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Licensing details for: 13951

Name: ELYSIAN DENTAL GROUP, DAVID C YANG DDS, INC.

License Type: Fictitious Name Permit

Primary Status: Cancelled

Organization Classification: Corporation

Address of Record

2549 HUNTINGTON DR #101
SAN MARINO CA 91108
LOS ANGELES county
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Practice Location

2549 HUNTINGTON DR #101
SAN MARINO CA 91108
LOS ANGELES county
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Issuance Date

December 26, 2017

Expiration Date

May 31, 2018

Current Date / Time

June 6, 2025
10:4:5 AM

License Relationships

FNP Owners

License/Registration Role: Fictitious Name Permit

Related Party Role: Owners

Name: YANG, DAVID C

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: YANG, DAVID C

License/Registration Type: Dentist License

License Number: 101773 Primary Status: Current - Active

Address :
1406 Atlantic Ave
LONG BEACH CA 90813-2013

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