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Licensing details for: 698

Name: KIM, JESSICA SOAH

License Type: Conscious Sedation

Primary Status: Cancelled

Address of Record

1111 6TH AVE
STE 510
SAN DIEGO CA 92101
SAN DIEGO county
Map

Issuance Date

May 12, 2010

Expiration Date

November 30, 2023

Current Date / Time

December 13, 2025
7:55:53 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: KIM, JESSICA SOAH

License/Registration Type: Dentist License

License Number: 58855 Primary Status: Current - Active

Address :
1111 6th Ave
Ste 510
SAN DIEGO CA 92101-5209
SAN DIEGO COUNTY

Map

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