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Licensing details for: 639

Name: TANG, SOPHEAP

License Type: Conscious Sedation

Primary Status: Cancelled

Address of Record

18876 Van Buren Blvd.
STE 107
RIVERSIDE CA 92508
RIVERSIDE county
Map

Issuance Date

September 24, 2008

Expiration Date

May 31, 2024

Current Date / Time

December 13, 2025
1:59:40 PM

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: TANG, SOPHEAP

License/Registration Type: Dentist License

License Number: 56393 Primary Status: Current - Active

Address :
18876 Van Buren Blvd.
STE 107
RIVERSIDE CA 92508
RIVERSIDE COUNTY

Map

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