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Licensing details for: 102433

Name: LEE, ALEXANDER

License Type: Dentist

Primary Status: Current - Active

Method of Application: Licensure by WREB

Address of Record

25 OAKMONT DR
DALY CITY CA 94015-3541
SAN MATEO county
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Practice Location

15422 Crenshaw Blvd
GARDENA CA 90249-4524
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3721 S La Brea Ave
LOS ANGELES CA 90016-5309
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Issuance Date

May 11, 2018

Expiration Date

August 31, 2025

Current Date / Time

June 6, 2025
4:14:35 PM

License Relationships

FNP Owners

License/Registration Role: Owners

Related Party Role: Fictitious Name Permit

Name: MAILEE MODERN DENTISTRY DENTAL PRACTICE OF DR. JENNIFER MAI & DR. ALEXANDER LEE

License/Registration Type: Fictitious Name Permit

License Number: 16078 Primary Status: Current - Active

Address :
15422 CRENSHAW BLVD
GARDENA CA 90249
LOS ANGELES COUNTY

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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: MAILEE MODERN DENTISTRY DENTAL PRACTICE OF DR. JENNIFER MAI & DR. ALEXANDER LEE

License/Registration Type: Fictitious Name Permit

License Number: 16078 Primary Status: Current - Active

Address :
15422 CRENSHAW BLVD
GARDENA CA 90249
LOS ANGELES COUNTY

Map

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