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Licensing details for: 5829

Name: LIVERMORE DENTAL GROUP, SUDHA CHINTA, DDS, A

License Type: Fictitious Name Permit

Primary Status: Cancelled

Organization Classification: Corporation

Address of Record

867 E STANLEY BLVD
LIVERMORE CA 94550
ALAMEDA county
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Issuance Date

November 4, 2005

Expiration Date

November 30, 2021

Current Date / Time

June 22, 2025
3:32:28 AM

License Relationships

FNP Owners

License/Registration Role: Fictitious Name Permit

Related Party Role: Owners

Name: CHINTA, SUDHA SESHA

Address Not Disclosed

FNP Owners

License/Registration Role: Fictitious Name Permit

Related Party Role: Owners

Name: CHINTA, SUDHA

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: CHINTA, SUDHA SESHA

License/Registration Type: Dentist License

License Number: 43769 Primary Status: Current - Active

Address :
103 SYCAMORE VALLEY ROAD WEST
DANVILLE CA 94526
CONTRA COSTA COUNTY

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