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Licensing details for: 110270

Name: CHO, TAEWON TAD

License Type: Dentist

Primary Status: Current - Active

Method of Application: Licensure by ADEX

Address of Record

2465 Iron Point Rd
#120
FOLSOM CA 95630-8754
SACRAMENTO county
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Issuance Date

July 2, 2024

Expiration Date

October 31, 2027

Current Date / Time

April 3, 2026
4:54:16 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: Crocker Ranch Dentistry, Dental Group of Crocker Ranch Dentistry, Prof. Corp.

License/Registration Type: Fictitious Name Permit

License Number: 20489 Primary Status: Current - Active

Address :
9055 Woodcreek Oaks Blvd. Suite 150
ROSEVILLE CA 95747

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