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Licensing details for: 58855

Name: KIM, JESSICA SOAH

License Type: Dentist

Primary Status: Current - Active

Secondary Status: Licensure by Residency

Address of Record

1111 6TH AVE
STE 510
SAN DIEGO CA 92101
SAN DIEGO county
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Practice Location

1111 6th Ave
Ste 510
SAN DIEGO CA 92101-5209
SAN DIEGO county
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Issuance Date

September 21, 2009

Expiration Date

November 30, 2027

Current Date / Time

December 15, 2025
12:40:21 PM

License Relationships

CS to DDS, OMS, or SP

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

Related Party Role: Conscious Sedation Permit

Name: KIM, JESSICA SOAH

License/Registration Type: Conscious Sedation Permit

License Number: 698 Primary Status: Cancelled

Address :
1111 6TH AVE
STE 510
SAN DIEGO CA 92101
SAN DIEGO COUNTY

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