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Licensing details for: 63515

Name: JOHNSON, REUBEN LEE

License Type: Dentist

Primary Status: Current - Active

Method of Application: Licensure by Residency

Secondary Status: Licensure by Residency

Previous Names: JOHNSON, REUREN LEE

Address of Record

17875 Von Karman Ave.
Suite 440
IRVINE CA 92614
LOS ANGELES county
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Practice Location

17875 Von Karman Ave.
Suite 440
IRVINE CA 92614
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Issuance Date

June 24, 2014

Expiration Date

November 30, 2026

Current Date / Time

May 30, 2026
9:57:57 AM

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: JOHNSON, REUBEN LEE

License/Registration Type: Conscious Sedation Permit

License Number: 909 Primary Status: Cancelled

Address :
5127 PARKGLEN AVE
LOS ANGELES CA 90043
LOS ANGELES COUNTY

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