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Licensing details for: 16938

Name: BLUE OAK DENTAL ROCKLIN, A DENTAL OFFICE OF ARENA GADE WILKES MILLA MCCLURE DENTAL CORPORATION

License Type: Fictitious Name Permit

Primary Status: Expired Primary Status Definition

Organization Classification: Corporation

Address of Record

5410 PARK DR
ROCKLIN CA 95765
PLACER county
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Practice Location

5410 Park Dr
ROCKLIN CA 95765
PLACER county
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Issuance Date

December 17, 2021

Expiration Date

April 30, 2022

Current Date / Time

June 6, 2025
1:54:48 PM

License Relationships

FNP Owners

License/Registration Role: Fictitious Name Permit

Related Party Role: Owners

Name: ARENA, MARK EDWARD

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: CHAUDHRY, MANU

License/Registration Type: Dentist License

License Number: 58484 Primary Status: Current - Active

Address :
24239 Hesperian Blvd
HAYWARD CA 94545-1526
ALAMEDA COUNTY

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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: ARENA, MARK EDWARD

License/Registration Type: Dentist License

License Number: 31559 Primary Status: Current - Active

Address :
5410 PARK DRIVE
ROCKLIN CA 95765
PLACER COUNTY

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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: WILKES, ALLEN RANDEL

License/Registration Type: Dentist License

License Number: 30985 Primary Status: Current - Active

Address :
15 Sierra Gate Plz
ROSEVILLE CA 95678-6602
PLACER COUNTY

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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: MCCLURE, JEFFREY SCOTT

License/Registration Type: Dentist License

License Number: 43818 Primary Status: Current - Active

Address :
15 Sierra Gate Plz
ROSEVILLE CA 95678-6602
PLACER COUNTY

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