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Licensing details for: 16888

Name: SOUTH MAIN DENTAL GROUP/MEDHAT ROFAEL

License Type: Fictitious Name Permit

Primary Status: Expired Primary Status Definition

Organization Classification: Corporation

Address of Record

1417 S. MAIN ST.
SANTA ANA CA 92707
ORANGE county
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Practice Location

1417 S. MAIN ST.
SANTA ANA CA 92707
ORANGE county
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Issuance Date

November 4, 2021

Expiration Date

June 30, 2024

Current Date / Time

June 13, 2026
6:14:47 PM

License Relationships

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: ROFAEL, MEDHAT M. RAOUF

License/Registration Type: Dentist License

License Number: 40714 Primary Status: Current - Active

Address :
17150 Euclid St Ste 322
FOUNTAIN VALLEY CA 92708-4092
ORANGE COUNTY

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