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Licensing details for: 20267

Name: La Verne Dental Group

License Type: Fictitious Name Permit

Primary Status: Current - Active

Organization Classification: Corporation

Address of Record

2216 Foothill Blvd
LA VERNE CA 91750
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Issuance Date

February 9, 2026

Expiration Date

February 29, 2028

Current Date / Time

April 2, 2026
1:12:32 AM

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: CHOKKA, SUDHAKAR RAO

License/Registration Type: Dentist License

License Number: 41376 Primary Status: Current - Active

Address :
27949 Greenspot Rd
Ste. H
HIGHLAND CA 92346-4443
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: ZAKLAMA, KARIM MAGID

License/Registration Type: Dentist License

License Number: 61349 Primary Status: Current - Active

Address :
2700 E Workman Ave
WEST COVINA CA 91791-6625
LOS ANGELES 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: SLADE, MICHELLE GONZALES

License/Registration Type: Dentist License

License Number: 104589 Primary Status: Current - Active

Address :
2216 Foothill Blvd
LA VERNE CA 91750-2944
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: LENG, NATHANIEL WEN-WEI

License/Registration Type: Dentist License

License Number: 61763 Primary Status: Current - Active

Address :
34880 Yucaipa Blvd
YUCAIPA CA 92399-4235
SAN BERNARDINO COUNTY

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