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Licensing details for: 3296

Name: DAVIS FAMILY DENTISTRY

License Type: Fictitious Name Permit

Primary Status: Cancelled

Organization Classification: Partnership

Address of Record

2043 ANDERSON ROAD SUITE A
DAVIS CA 95616
YOLO county
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Issuance Date

July 12, 2001

Expiration Date

May 31, 2005

Current Date / Time

June 7, 2025
9:58:56 AM

License Relationships

FNP Owners

License/Registration Role: Fictitious Name Permit

Related Party Role: Owners

Name: KHODAI, SHAHRAM

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: KHODAI, SHAHRAM

License/Registration Type: Dentist License

License Number: 43027 Primary Status: Current - Active

Address :
3517 Marconi Ave #105
SACRAMENTO CA 95821
SACRAMENTO COUNTY

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