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Licensing details for: 9563

Name: IMAGE ORTHODONTICS, DENTAL PRACTICE, YAN KALIKA DENTAL CORPORATIO

License Type: Fictitious Name Permit

Primary Status: Cancelled

Organization Classification: Corporation

Previous Names: YAN KALIKA DENTAL CORPORATION DBA: IMAGE ORTHODONTICS

Address of Record

641 W. ROUTE 66, STE. E
GLENDORA CA 91740
LOS ANGELES county
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Practice Location

641 W. ROUTE 66, STE. E
GLENDORA CA 91740
LOS ANGELES county
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Issuance Date

October 4, 2011

Expiration Date

April 30, 2020

Current Date / Time

June 7, 2025
8:26:35 AM

License Relationships

FNP Owners

License/Registration Role: Fictitious Name Permit

Related Party Role: Owners

Name: KALIKA, YAN

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: KALIKA, YAN

License/Registration Type: Dentist License

License Number: 45886 Primary Status: Current - Active

Address :
3075 Beacon Blvd
WEST SACRAMENTO CA 95691-3462
SACRAMENTO COUNTY

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