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Licensing details for: 17847

Name: MISSION DENTAL GROUP, VALA DENTAL CORPORATION

License Type: Fictitious Name Permit

Primary Status: Current - Active

Organization Classification: Corporation

Address of Record

26032 MARGUERITE PARKWAY, SUITE A-1
MISSION VIEJO CA 92692
ORANGE county
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Practice Location

26032 MARGUERITE PARKWAY, SUITE A-1
Suite A-1
MISSION VIEJO CA 92692
ORANGE county
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Issuance Date

May 17, 2023

Expiration Date

June 30, 2026

Current Date / Time

June 6, 2025
2:2:42 AM

License Relationships

FNP Owners

License/Registration Role: Fictitious Name Permit

Related Party Role: Owners

Name: VALA, GHAZAL

Address Not Disclosed

FNP Owners

License/Registration Role: Fictitious Name Permit

Related Party Role: Owners

Name: GHAZAL, CAROLYN G

Address Not Disclosed

FNP Owners

License/Registration Role: Fictitious Name Permit

Related Party Role: Owners

Name: SHARIFIAN, ALEX R.

Address Not Disclosed

FNP Owners

License/Registration Role: Fictitious Name Permit

Related Party Role: Owners

Name: REAGAN, DARIN SCOTT

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: SHARIFIAN, ALEX R.

License/Registration Type: Dentist License

License Number: 44540 Primary Status: Current - Active

Address :
13721 Newport Ave
Suite 1
TUSTIN CA 92780-4690
ORANGE COUNTY

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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: REAGAN, DARIN SCOTT

License/Registration Type: Dentist License

License Number: 34407 Primary Status: Current - Active

Address :
943 AVENIDA PICO, STE. A
SAN CLEMENTE CA 92673
ORANGE COUNTY

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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: GHAZAL, CAROLYN G

License/Registration Type: Dentist License

License Number: 38682 Primary Status: Current - Active

Address :
10797 FOOTHILL BLVD
RANCHO CUCAMONGA CA 91730
SAN BERNARDINO COUNTY

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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: VALA, GHAZAL

License/Registration Type: Dentist License

License Number: 57587 Primary Status: Current - Active

Address :
26032 Marguerite Pkwy
Ste A-1
MISSION VIEJO CA 92692-5281
ORANGE COUNTY

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