Dental Board of California
Licensing details for: 9583
Name: BLUE OAK DENTAL ROCKLIN, A DENTAL OFFICE OF ARENA GADE WILKES DEN
License Type: Fictitious Name Permit
Primary Status: Cancelled
Organization Classification: Corporation
Previous Names: BLUE OAK DENTAL ROCKLIN
License Relationships
FNP Owners
License/Registration Role: Fictitious Name Permit
Related Party Role: Owners
Name: WILKES, ALLEN RANDEL
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: WILKES, ALLEN RANDEL
License/Registration Type: Dentist License
License Number: 30985 Primary Status: Current - Active
Address :
15 Sierra Gate Plz
ROSEVILLE CA 95678-6602
PLACER COUNTY
