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Licensing details for: 14490

Name: VALLE SMILES SMILES- DENTAL PRACTICE OF YAN KALIKA DENTAL CORPORATION

License Type: Fictitious Name Permit

Primary Status: Cancelled

Organization Classification: Corporation

Address of Record

2990 W. GRANT LINE RD
TRACY CA 95304
SAN JOAQUIN county
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Practice Location

2990 W. GRANT LINE RD
TRACY CA 95304
SAN JOAQUIN county
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Issuance Date

October 9, 2018

Expiration Date

April 30, 2020

Current Date / Time

June 6, 2025
10:1:59 AM

License Relationships

FNP Owners

License/Registration Role: Fictitious Name Permit

Related Party Role: Owners

Name: KALIKA, YAN

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: KALIKA, YAN

License/Registration Type: Dentist License

License Number: 45886 Primary Status: Current - Active

Address :
3075 Beacon Blvd
WEST SACRAMENTO CA 95691-3462
SACRAMENTO COUNTY

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