Dental Board of California
Licensing details for: 17082
Name: STAR TEK ADULT DENTAL GROUP OF JERRY L. LANIER, D.D.S., INC.
License Type: Fictitious Name Permit
Primary Status: Expired
Organization Classification: Corporation
License Relationships
FNP Owners
License/Registration Role: Fictitious Name Permit
Related Party Role: Owners
Name: LANIER, JERRY LEE
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: LANIER, JERRY LEE
License/Registration Type: Dentist License
License Number: 40088 Primary Status: Current - Active
Address :
2215 N VERMONT AVENUE
LOS ANGELES CA 90027
LOS ANGELES COUNTY
