Dental Board of California
Licensing details for: 4453
Name: BLUE OAK DENTAL GROUP, ARENA, GADE, WILKES DENTAL
License Type: Fictitious Name Permit
Primary Status: Cancelled
Organization Classification: Corporation
Address of Record
5410 PARK DR
ROCKLIN CA 95765
PLACER county
Map
License Relationships
FNP Owners
License/Registration Role: Fictitious Name Permit
Related Party Role: Owners
Name: WILKES, ALLEN RANDEL
Address Not Disclosed
FNP Owners
License/Registration Role: Fictitious Name Permit
Related Party Role: Owners
Name: ARENA, MARK EDWARD
Address Not Disclosed
FNP Owners
License/Registration Role: Fictitious Name Permit
Related Party Role: Owners
Name: GADE, MICHAEL DUANE
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: WILKES, ALLEN RANDEL
License/Registration Type: Dentist License
License Number: 30985 Primary Status: Current - Active
Address :
15 Sierra Gate Plz
ROSEVILLE CA 95678-6602
PLACER COUNTY
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: GADE, MICHAEL DUANE
License/Registration Type: Dentist License
License Number: 31463 Primary Status: Expired
Address :
15 SIERRA GATE PLAZA
ROSEVILLE CA 95678
PLACER COUNTY
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: ARENA, MARK EDWARD
License/Registration Type: Dentist License
License Number: 31559 Primary Status: Current - Active
Address :
5410 PARK DRIVE
ROCKLIN CA 95765
PLACER COUNTY
