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Licensing details for: 54854

Name: LEE, SEONG WOOK

License Type: Dentist

Primary Status: Current - Active

Method of Application: Licensure by WREB

Address of Record

501 Lakeside Dr
FULLERTON CA 92835-1509
ORANGE county
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Practice Location

11438 Kenyon way #3C
3C
RANCHO CUCAMONGA CA 91701
SAN BERNARDINO county
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27174 Newport Rd
suite 1
MENIFEE CA 92584-7384
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Issuance Date

August 24, 2006

Expiration Date

August 31, 2027

Current Date / Time

April 3, 2026
4:54:19 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: Novato Smiles Dentistry, Dental Group of Novato Smiles Dentistry, Inc.

License/Registration Type: Fictitious Name Permit

License Number: 20213 Primary Status: Current - Active

Address :
948 Diablo Ave.
NOVATO CA 94947

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