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Licensing details for: 8460

Name: AFFINITY DENTAL OF SOUTHBAY, DENTAL OFFICE OF DR. DONALD A. GALLO

License Type: Fictitious Name Permit

Primary Status: Cancelled

Organization Classification: Corporation

Address of Record

290 LANDIS AVE.
STE. A & B
CHULA VISTA CA 91910
SAN DIEGO county
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Issuance Date

October 22, 2009

Expiration Date

November 30, 2016

Current Date / Time

June 7, 2025
3:8:25 PM

License Relationships

FNP Owners

License/Registration Role: Fictitious Name Permit

Related Party Role: Owners

Name: MICHELS, ALAN G

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: MICHELS, ALAN G

License/Registration Type: Dentist License

License Number: 19777 Primary Status: Current - Active

Address :
3529 Castleman Ln
BURBANK CA 91504-1663
LOS ANGELES COUNTY

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