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Licensing details for: 17833

Name: SOUTHERN CALIFORNIA CENTER FOR ORAL & FACIAL SURGERY DENTAL PRACTICE OF SIRISH MAKAN, DDS

License Type: Fictitious Name Permit

Primary Status: Expired Primary Status Definition

Organization Classification: Corporation

Address of Record

18372 CLARK ST STE 224
TARZANA CA 91356
LOS ANGELES county
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Practice Location

18372 CLARK ST STE 224
TARZANA CA 91356
LOS ANGELES county
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Issuance Date

May 10, 2023

Expiration Date

June 30, 2023

Current Date / Time

December 16, 2025
9:45:49 PM

License Relationships

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: MAKAN, SIRISH

License/Registration Type: Dentist License

License Number: 65305 Primary Status: Current - Active

Address :
10601 Paramount Blvd
DOWNEY CA 90241-3303
LOS ANGELES COUNTY

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