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Licensing details for: 13939

Name: JUNGLE DENTAL, PRACTICE OF SOROUR DMD CORPORATION

License Type: Fictitious Name Permit

Primary Status: Current - Active

Organization Classification: Corporation

Address of Record

4138 MAINE AVE UNIT M2
BALDWIN PARK CA 91706
LOS ANGELES county
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Practice Location

4138 MAINE AVE UNIT M2
BALDWIN PARK CA 91706
LOS ANGELES county
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Issuance Date

December 21, 2017

Expiration Date

June 30, 2026

Current Date / Time

June 6, 2025
2:59:51 PM

License Relationships

FNP Owners

License/Registration Role: Fictitious Name Permit

Related Party Role: Owners

Name: SOROUR, SELVANA

Address Not Disclosed

FNP Owners

License/Registration Role: Fictitious Name Permit

Related Party Role: Owners

Name: SOROUR, THARWAT

Address Not Disclosed

FNP to DDS or OMS

License/Registration Role: Fictitious Name Permit

Related Party Role: Must hold an active Dental License, or Oral Maxillofacial Surgery Permit

Name: SOROUR, THARWAT

License/Registration Type: Dentist License

License Number: 54393 Primary Status: Current - Active

Address :
13340 HAWTHORNE BLVD
HAWTHORNE CA 90250
LOS ANGELES COUNTY

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FNP to DDS or OMS

License/Registration Role: Fictitious Name Permit

Related Party Role: Must hold an active Dental License, or Oral Maxillofacial Surgery Permit

Name: SOROUR, SELVANA

License/Registration Type: Dentist License

License Number: 54394 Primary Status: Current - Active

Address :
13340 HAWTHORNE BLVD
HAWTHORNE CA 90250
LOS ANGELES COUNTY

Map

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