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Licensing details for: 4776

Name: IMPERIAL DENTAL PRACTICE, CHOKKA DENTAL CORPORATION

License Type: Fictitious Name Permit

Primary Status: Cancelled

Organization Classification: Corporation

Address of Record

34880 YUCAIPA BLVD
YUCAIPA CA 92399
SAN BERNARDINO county
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Issuance Date

February 24, 2004

Expiration Date

November 30, 2016

Current Date / Time

December 13, 2025
3:23:57 PM

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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