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Licensing details for: 1189

Name: SWAYAMPRAKASAM, LOGESH

License Type: Conscious Sedation

Primary Status: Cancelled

Address of Record

4688 Mowry Ave
FREMONT CA 94538-1148
ALAMEDA county
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Issuance Date

April 16, 2019

Expiration Date

July 31, 2024

Current Date / Time

June 6, 2025
1:52:14 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: SWAYAMPRAKASAM, LOGESH

License/Registration Type: Dentist License

License Number: 100140 Primary Status: Current - Active

Address :
3200 Mowry avenue
Suite 102
FREMONT CA 94538

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