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Licensing details for: 1874

Name: KIM, JAMES YONG

License Type: Dentist General Anesthesia

Primary Status: Cancelled

Address of Record

930 MILMADA DR
LA CANADA FLINTRIDGE CA 91011
LOS ANGELES county
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Practice Location

17003 Bear Valley Rd, D
HESPERIA CA 92345
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23082 RIDGE ROUTE DR STE A
LAKE FOREST CA 92630
ORANGE county
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9349 E FOOTHILL BLVD STE B
RANCHO CUCAMONGA CA 91730
SAN BERNARDINO county
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Issuance Date

December 12, 2017

Expiration Date

January 31, 2023

Current Date / Time

June 6, 2025
2:16:20 AM

License Relationships

GA to DDS or OMS or SP

License/Registration Role: General Anesthesia Permit

Related Party Role: Must hold an active Dental License, Oral Maxillofacial Surgery Permit, or Special Permit

Name: KIM, JAMES YONG

License/Registration Type: Oral Maxillofacial Surgery Permit

License Number: 113 Primary Status: Cancelled

Address :
930 MILMADA DR
LA CANADA FLINTRIDGE CA 91011-2522
LOS ANGELES COUNTY

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