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Licensing details for: 105313

Name: JI, MINHYUNG

License Type: Dentist

Primary Status: Current - Active

Method of Application: Licensure by WREB

Address of Record

962 Sepulveda Blvd
HARBOR CITY CA 90710-1405
LOS ANGELES county
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Issuance Date

August 17, 2020

Expiration Date

March 31, 2027

Current Date / Time

April 4, 2026
5:43:08 AM

License Relationships

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: Harbor City Modern Dentistry Dental Group of Harbor City Modern Dentistry, Inc.

License/Registration Type: Fictitious Name Permit

License Number: 20287 Primary Status: Current - Active

Address :
962 Sepulveda Blvd
HARBOR CITY CA 90710-1405
LOS ANGELES COUNTY

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