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Licensing details for: 48761

Name: DIXON, STEPHANIE LEE

License Type: Dentist

Primary Status: Current - Active

Previous Names: PETERSON, STEPHANIE LEE

Address of Record

5627 OBERLIN DR #100
SAN DIEGO CA 92121
SAN DIEGO county
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Issuance Date

August 27, 2001

Expiration Date

July 31, 2027

Current Date / Time

June 7, 2025
12:46:16 PM

License Relationships

OCS to DDS, OMS, or SP

License/Registration Role: Must hold an active Dental License, Oral Maxillofacial Surgery Permit, or Special Permit

Related Party Role: Oral Conscious Sedation Certificate

Name: DIXON, STEPHANIE LEE

License/Registration Type: Oral Conscious Sedation Certificate

License Number: 603 Primary Status: Cancelled

Address :
5627 OBERLIN DR STE 100
SAN DIEGO CA 92121
SAN DIEGO COUNTY

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