Dental Board of California
Licensing details for: 1550
Name: VICTORIAN DENTAL GROUP, THEODOROU PROFESSIONAL DENTAL CORP
License Type: Fictitious Name Permit
Primary Status: Current - Active
Organization Classification: Corporation
Previous Names: VICTORIAN DENTAL GROUP, DR. LARISA THEODOROU
Address of Record
19717 SHERMAN WAY
CANOGA PARK CA 91306
LOS ANGELES county
Map
License Relationships
FNP Owners
License/Registration Role: Fictitious Name Permit
Related Party Role: Owners
Name: THEODOROU, NIKOLAOS
Address Not Disclosed
FNP Owners
License/Registration Role: Fictitious Name Permit
Related Party Role: Owners
Name: THEODOROU, LARISA
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: THEODOROU, NIKOLAOS
License/Registration Type: Dentist License
License Number: 40029 Primary Status: Current - Active
Address :
19717 SHERMAN WAY
CANOGA PARK CA 91306
LOS ANGELES COUNTY
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: THEODOROU, LARISA
License/Registration Type: Dentist License
License Number: 42430 Primary Status: Current - Active
Address :
19717 SHERMAN WAY
CANOGA PARK CA 91306
LOS ANGELES COUNTY
