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Licensing details for: 19203

Name: WHITTIER SURGICAL ARTS BY ELDER DENTAL GROUP, P.C.

License Type: Fictitious Name Permit

Primary Status: Expired Primary Status Definition

Organization Classification: Corporation

Address of Record

13203 HADLEY STREET., SUITE 101
WHITTIER CA 90601
LOS ANGELES county
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Practice Location

13203 HADLEY STREET., SUITE 101
WHITTIER CA 90601
LOS ANGELES county
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Issuance Date

December 23, 2024

Expiration Date

January 31, 2025

Current Date / Time

June 6, 2025
1:29:38 PM

License Relationships

FNP Owners

License/Registration Role: Fictitious Name Permit

Related Party Role: Owners

Name: ELDER, MAHR F

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: ELDER, MAHR F

License/Registration Type: Dentist License

License Number: 46586 Primary Status: Current - Active

Address :
1805 Novato Blvd
Suite 1
NOVATO CA 94947-2934
MARIN COUNTY

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