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Licensing details for: 9885

Name: DIAMOND DENTAL AND ORTHODONTICS, DENTAL OFFICE OF POURSHIRAZI, H.

License Type: Fictitious Name Permit

Primary Status: Cancelled

Organization Classification: Corporation

Previous Names: DIAMOND DENTAL AND ORTHODONTICS DENTAL OFFICE OF POURSHIRAZI, H. CORPORATION

Address of Record

31500 GRAPE STREET, STE. 8
LAKE ELSINORE CA 92532
RIVERSIDE county
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Practice Location

31500 GRAPE STREET, STE. 8
LAKE ELSINORE CA 92532
RIVERSIDE county
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Issuance Date

April 19, 2012

Expiration Date

January 31, 2014

Current Date / Time

April 2, 2026
11:32:14 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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