Dental Board of California
Licensing details for: 64182
Name: CHUNG, SUSAN LEE
License Type: Dentist
Primary Status: Current - Active
Method of Application: Licensure by WREB
Practice Location
12455 Victoria Gardens Ln
Suite 190
RANCHO CUCAMONGA CA 91739-7530
Map
License Relationships
AO to DDS or OMS (Owners)
License/Registration Role: Must hold an active Dental License, or Oral Maxillofacial Surgery Permit
Related Party Role: Additional Office Permit
Name: HSIEH AND CHUNG DENTAL CORPORATION
License/Registration Type: Additional Office Permit
License Number: 79986 Primary Status: Current - Active
Address :
12455 VICTORIA GARDENS LANE #190
RANCHO CUCAMONGA CA 91739
SAN BERNARDINO COUNTY
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: MONET DENTAL GROUP HSIEH AND CHUNG DENTAL CORPORATION
License/Registration Type: Fictitious Name Permit
License Number: 14819 Primary Status: Current - Active
Address :
12455 VICTORIA GARDENS LANE., SUITE 190
RANCHO CUCAMONGA CA 91739
SAN BERNARDINO COUNTY
