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Licensing details for: 14352

Name: KP DENTAL, PRACTICE OF KATYUSKA PAREDES LOPEZ, DDS, APC

License Type: Fictitious Name Permit

Primary Status: Expired Primary Status Definition

Organization Classification: Corporation

Address of Record

615 N. BENSON AVE, STE F
UPLAND CA 91786
SAN BERNARDINO county
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Practice Location

615 N. BENSON AVE, STE F
UPLAND CA 91786
SAN BERNARDINO county
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Issuance Date

July 25, 2018

Expiration Date

October 31, 2021

Current Date / Time

June 6, 2025
10:8:3 AM

License Relationships

FNP Owners

License/Registration Role: Fictitious Name Permit

Related Party Role: Owners

Name: LOPEZ, KATYUSKA PAREDES

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: LOPEZ, KATYUSKA PAREDES

License/Registration Type: Dentist License

License Number: 50967 Primary Status: Current - Active

Address :
23318 Olive Wood Plaza Dr
Suite C
MORENO VALLEY CA 92553-5219
RIVERSIDE COUNTY

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