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Licensing details for: 909

Name: JOHNSON, REUBEN LEE

License Type: Conscious Sedation

Primary Status: Cancelled

Previous Names: JOHNSON, REUREN LEE

Address of Record

5127 PARKGLEN AVE
LOS ANGELES CA 90043
LOS ANGELES county
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Issuance Date

November 24, 2014

Expiration Date

October 4, 2016

Current Date / Time

June 6, 2025
9:48:57 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: JOHNSON, REUBEN LEE

License/Registration Type: Dentist License

License Number: 63515 Primary Status: Current - Active

Address :
17875 Von Karman Ave.
Suite 440
IRVINE CA 92614

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