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Licensing details for: 18395

Name: LILAC PEDIATRIC DENTAL GROUP DR. FLYNNE WEINGARTEN AND ASSOCIATES

License Type: Fictitious Name Permit

Primary Status: Current - Active

Organization Classification: Corporation

Address of Record

12660 RIVERSIDE DR., SUITE 210
VALLEY VILLAGE CA 91607
LOS ANGELES county
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Practice Location

12660 RIVERSIDE DR., SUITE 210
VALLEY VILLAGE CA 91607
LOS ANGELES county
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Issuance Date

February 7, 2024

Expiration Date

June 30, 2025

Current Date / Time

June 7, 2025
10:6:11 AM

License Relationships

FNP Owners

License/Registration Role: Fictitious Name Permit

Related Party Role: Owners

Name: WEINGARTEN, FLYNNE V

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: WEINGARTEN, FLYNNE V

License/Registration Type: Dentist License

License Number: 101046 Primary Status: Current - Active

Address :
2930 VENTURA BLVD #226
STUDIO CITY CA 91604
LOS ANGELES COUNTY

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