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Licensing details for: 1247

Name: PHAM, CHRISTOPHER TIEN

License Type: Conscious Sedation

Primary Status: Cancelled

Address of Record

440 N Barranca Ave
#7034
COVINA CA 91723-1722
LOS ANGELES county
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Practice Location

13197 CENTRAL AVE
#201
CHINO CA 91710-4178
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Issuance Date

October 30, 2020

Expiration Date

October 31, 2024

Current Date / Time

June 6, 2025
1:53:36 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: PHAM, CHRISTOPHER TIEN

License/Registration Type: Dentist License

License Number: 105532 Primary Status: Current - Active

Address :
13197 Central Ave
#201
CHINO CA 91710-4178
SAN BERNARDINO COUNTY

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