Dental Board of California
Licensing details for: 100095
Name: LEE, JASON SANGJAE
License Type: Dentist
Primary Status: Current - Active
Method of Application: Licensure by WREB
License Relationships
AO to DDS or OMS (Owners)
License/Registration Role: Must hold an active Dental License, or Oral Maxillofacial Surgery Permit
Related Party Role: Additional Office Permit
Name: DENTAL CORPORATION OF JASON LEE
License/Registration Type: Additional Office Permit
License Number: 81564 Primary Status: Current - Active
Address :
8854 MADISON AVE
FAIR OAKS CA 95628
SACRAMENTO COUNTY
AO to DDS or OMS (Owners)
License/Registration Role: Must hold an active Dental License, or Oral Maxillofacial Surgery Permit
Related Party Role: Additional Office Permit
Name: DENTAL CORPORATION OF JASON LEE
License/Registration Type: Additional Office Permit
License Number: 81412 Primary Status: Cancelled
Address :
8908 MADISON AVENUE
FAIR OAKS CA 95628
SACRAMENTO COUNTY
FNP Owners
License/Registration Role: Owners
Related Party Role: Fictitious Name Permit
Name: DENTISTS OF FAIR OAKS DENTAL GROUP, DENTAL CORPORATION OF JASON LEE
License/Registration Type: Fictitious Name Permit
License Number: 17936 Primary Status: Expired
Address :
8854 Madison Avenue
FAIR OAKS CA 95628
SACRAMENTO COUNTY
FNP Owners
License/Registration Role: Owners
Related Party Role: Fictitious Name Permit
Name: RIVER CITY DENTAL GROUP, DENTAL CORPORATION OF JASON LEE
License/Registration Type: Fictitious Name Permit
License Number: 17617 Primary Status: Cancelled
Address :
8908 MADISON AVENUE
FAIR OAKS CA 95628
SACRAMENTO COUNTY
FNP to DDS or OMS
License/Registration Role: Must hold an active Dental License, or Oral Maxillofacial Surgery Permit
Related Party Role: Fictitious Name Permit
Name: RIVER CITY DENTAL GROUP, DENTAL CORPORATION OF JASON LEE
License/Registration Type: Fictitious Name Permit
License Number: 17617 Primary Status: Cancelled
Address :
8908 MADISON AVENUE
FAIR OAKS CA 95628
SACRAMENTO COUNTY
FNP to DDS or OMS
License/Registration Role: Must hold an active Dental License, or Oral Maxillofacial Surgery Permit
Related Party Role: Fictitious Name Permit
Name: DENTISTS OF FAIR OAKS DENTAL GROUP, DENTAL CORPORATION OF JASON LEE
License/Registration Type: Fictitious Name Permit
License Number: 17936 Primary Status: Expired
Address :
8854 Madison Avenue
FAIR OAKS CA 95628
SACRAMENTO COUNTY
