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Licensing details for: 17743

Name: JIN DENTAL AESTHETICS DENTAL OFFICE OF TIAN JIN DDS, INC

License Type: Fictitious Name Permit

Primary Status: Expired Primary Status Definition

Organization Classification: Corporation

Address of Record

788 E. WALNUT ST
PASADENA CA 91101
LOS ANGELES county
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Practice Location

788 E. WALNUT ST
PASADENA CA 91101
LOS ANGELES county
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Issuance Date

March 30, 2023

Expiration Date

December 31, 2024

Current Date / Time

June 21, 2025
9:28:38 PM

License Relationships

FNP Owners

License/Registration Role: Fictitious Name Permit

Related Party Role: Owners

Name: JIN, TIAN

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: JIN, TIAN

License/Registration Type: Dentist License

License Number: 64980 Primary Status: Current - Active

Address :
788 E Walnut St
PASADENA CA 91101-1638
LOS ANGELES COUNTY

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