Dental Board of California
Licensing details for: 5909
Name: DENTISTRY AT EMPIRE LAKES, DENTAL PRACTICE OF
License Type: Fictitious Name Permit
Primary Status: Cancelled
Organization Classification: Sole Owner
Address of Record
9640 MILLIKEN AVE, UNIT 4
RANCHO CUCAMONGA CA 91730
SAN BERNARDINO county
Map
License Relationships
FNP Owners
License/Registration Role: Fictitious Name Permit
Related Party Role: Owners
Name: SERRANO, AINA P
Address Not Disclosed
FNP Owners
License/Registration Role: Fictitious Name Permit
Related Party Role: Owners
Name: SERRANO, AINA PALMADO
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: SERRANO, AINA PALMADO
License/Registration Type: Dentist License
License Number: 43477 Primary Status: Current - Active
Address :
6388 SHOW HORSE WAY
RANCHO CUCAMONGA CA 91739
SAN BERNARDINO COUNTY
