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Licensing details for: 17650

Name: IMAGE ORTHODONTICS - DENTAL PRACTICE OF YAN KALIKA DENTAL CORPORATION

License Type: Fictitious Name Permit

Primary Status: Expired Primary Status Definition

Organization Classification: Corporation

Address of Record

4200 EAST AVENUE #100
LIVERMORE CA 94550
ALAMEDA county
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Practice Location

4200 EAST AVENUE #100
LIVERMORE CA 94550
ALAMEDA county
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Issuance Date

February 14, 2023

Expiration Date

April 30, 2024

Current Date / Time

June 6, 2025
7:7:32 PM

License Relationships

FNP Owners

License/Registration Role: Fictitious Name Permit

Related Party Role: Owners

Name: KALIKA, YAN

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: KALIKA, YAN

License/Registration Type: Dentist License

License Number: 45886 Primary Status: Current - Active

Address :
3075 Beacon Blvd
WEST SACRAMENTO CA 95691-3462
SACRAMENTO COUNTY

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