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Licensing details for: 3563

Name: FAMILY ORTHODONTIC CENTER, DENTAL GROUP

License Type: Fictitious Name Permit

Primary Status: Cancelled

Organization Classification: Corporation

Address of Record

624 S EUCLID ST
ANAHEIM CA 92802
ORANGE county
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Issuance Date

March 12, 2002

Expiration Date

September 30, 2007

Current Date / Time

June 22, 2025
5:6:52 AM

License Relationships

FNP Owners

License/Registration Role: Fictitious Name Permit

Related Party Role: Owners

Name: MOUSSA, RAED Z

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: MOUSSA, RAED Z

License/Registration Type: Dentist License

License Number: 42577 Primary Status: Deceased

Address :
5810 E TRAPPER TRAIL
ANAHEIM CA 92807
ORANGE COUNTY

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