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Licensing details for: 9511

Name: MENIFEE VALLEY DENTAL GROUP, HOMAYOUN POURSHIRAZI, DMD, PROF. COR

License Type: Fictitious Name Permit

Primary Status: Cancelled

Organization Classification: Corporation

Address of Record

27192 NEWPORT ROAD, STE. 2
MENIFEE CA 92584
RIVERSIDE county
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Practice Location

27192 NEWPORT ROAD, STE. 2
MENIFEE CA 92584
RIVERSIDE county
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Issuance Date

August 29, 2011

Expiration Date

January 31, 2012

Current Date / Time

April 2, 2026
11:34:04 PM

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: POURSHIRAZI, HOMAYOUN

License/Registration Type: Dentist License

License Number: 44064 Primary Status: Current - Active

Address :
27192 Newport Rd
SUITE 2
MENIFEE CA 92584-7387
RIVERSIDE COUNTY

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