Business License Application
Business License Status
| What would you like to do today: |
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| Is this a: |
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| If you are are applying for a Prescott Valley local license, please select which Series you are applying for |
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Business Name and Physical Location
| Business name or Trade Name |
My Kids' Dentist Ryan S. Brown DDS PLLC
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| Nature of Ownership |
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| is the business location: |
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| Mailing Address (street address or PO Box) |
3626 Crossings Dr
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| Business Phone Number |
+19284455959
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| Number of Employees |
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| Please choose the most applicable to your business: |
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| Please read carefully through the following list and choose the closest description of your business: |
MEDICAL HEALTH SERVICES
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| Will your business be selling or serving alcohol? |
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| Locations where the business or applicant has operated during the last 5 years: |
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Applicant Information (Must be completed by the person filling out this application)
| Name (First and Last) |
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| Home Address (No PO Boxes) |
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| Mailing Address |
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| Phone number |
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Corporation Information
| State in which the LLC was legally established |
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| Name of the Business (if owned by another entity) |
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