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Licensing details for: 9126

Name: VERMONT FAMILY DENTISTRY, DENTAL OFFICE OF UPPAL DENTAL CORP.

License Type: Fictitious Name Permit

Primary Status: Cancelled

Organization Classification: Corporation

Previous Names: VERMONT FAMILY DENTISTRY

Address of Record

1014 N VERMONT AVENUE
LOS ANGELES CA 90029
LOS ANGELES county
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Practice Location

1014 N VERMONT AVENUE
LOS ANGELES CA 90029
LOS ANGELES county
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Issuance Date

January 4, 2011

Expiration Date

December 31, 2011

Current Date / Time

December 13, 2025
7:56:39 AM

License Relationships

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: UPPAL, GAGAN

License/Registration Type: Dentist License

License Number: 55640 Primary Status: Current - Active

Address :
360 S. Glendora Ave #1
WEST COVINA CA 91790
LOS ANGELES COUNTY

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