Dental Board of California
Licensing details for: 110488
Name: LY, JACQUELINE
License Type: Dentist
Primary Status: Current - Active
Method of Application: Licensure by ADEX
Address of Record
3330 E Foothill Blvd
342
PASADENA CA 91107-3123
LOS ANGELES county
Map
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: Alhambra Modern Dentistry, Dental Group of Alhambra Modern Dentistry, Inc.
License/Registration Type: Fictitious Name Permit
License Number: 20347 Primary Status: Current - Active
Address :
100 E Main St. #130
ALHAMBRA CA 91801
