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Licensing details for: 4962

Name: SOUTH OCEANSIDE DENTAL GROUP, REAGAN AND SHARIFIAN

License Type: Fictitious Name Permit

Primary Status: Cancelled

Organization Classification: Corporation

Address of Record

2484 VISTA WAY, STE B
OCEANSIDE CA 92054
SAN DIEGO county
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Issuance Date

May 19, 2004

Expiration Date

June 30, 2014

Current Date / Time

June 6, 2025
1:48:11 PM

License Relationships

FNP Owners

License/Registration Role: Fictitious Name Permit

Related Party Role: Owners

Name: REAGAN, DARIN SCOTT

Address Not Disclosed

FNP Owners

License/Registration Role: Fictitious Name Permit

Related Party Role: Owners

Name: SHARIFIAN, ALEX R.

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: SHARIFIAN, ALEX R.

License/Registration Type: Dentist License

License Number: 44540 Primary Status: Current - Active

Address :
13721 Newport Ave
Suite 1
TUSTIN CA 92780-4690
ORANGE 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: REAGAN, DARIN SCOTT

License/Registration Type: Dentist License

License Number: 34407 Primary Status: Current - Active

Address :
943 AVENIDA PICO, STE. A
SAN CLEMENTE CA 92673
ORANGE COUNTY

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