
Dental Board of California
Licensing details for: 17553
Name: SPRING DENTAL GROUP: BROCK LORENZ DENTAL CORPORATION
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: LORENZ, BROCK JASON
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: LORENZ, BROCK JASON
License/Registration Type: Dentist License
License Number: 61270 Primary Status: Current - Active
Address :
6622 Cedarwood Dr
HUNTINGTON BEACH CA 92648-6658
ORANGE COUNTY