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Licensing details for: 1114

Name: ASSAF, GINA DEANA

License Type: Conscious Sedation

Primary Status: Cancelled

Address of Record

1441 AVOCADO AVE SUITE 606
NEWPORT BEACH CA 92660
ORANGE county
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Practice Location

200 E Imperial Hwy
BREA CA 92821-4925
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Issuance Date

September 28, 2017

Expiration Date

August 31, 2024

Current Date / Time

June 6, 2025
1:52:20 AM

License Relationships

CS to DDS, OMS, or SP

License/Registration Role: Conscious Sedation Permit

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

Name: ASSAF, GINA DEANA

License/Registration Type: Dentist License

License Number: 61197 Primary Status: Current - Active

Address :
12791 Newport Ave
#100
TUSTIN CA 92780-2751
ORANGE COUNTY

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