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Licensing details for: 7992

Name: HIGHLAND DENTAL GROUP, JEFFERSON AND CHOKKA PROFESSIONAL DENTAL C

License Type: Fictitious Name Permit

Primary Status: Cancelled

Organization Classification: Corporation

Previous Names: HIGHLAND DENTAL GROUP

Address of Record

27949 GREENSPOT ROAD
STE. H
HIGHLAND CA 92346
SAN BERNARDINO county
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Practice Location

27949 GREENSPOT ROAD
STE. H
HIGHLAND CA 92346
SAN BERNARDINO county
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Issuance Date

February 26, 2009

Expiration Date

July 31, 2012

Current Date / Time

June 6, 2025
2:6:23 AM

License Relationships

FNP Owners

License/Registration Role: Fictitious Name Permit

Related Party Role: Owners

Name: CHOKKA, SUDHAKAR RAO

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: 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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