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Licensing details for: 1045

Name: KHODAI, SHAHRAM

License Type: Oral Conscious Sedation

Primary Status: Expired Primary Status Definition

Specialty: Adult

Secondary Status: Licensure by Residency

Address of Record

1501 Secret Ravine Pkwy
1224
ROSEVILLE CA 95661-6000
PLACER county
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Issuance Date

March 2, 2007

Expiration Date

May 31, 2021

Current Date / Time

April 4, 2026
7:57:05 AM

License Relationships

OCS to DDS, OMS, or SP

License/Registration Role: Oral Conscious Sedation Certificate

Related Party Role: Must hold an active Dental License, Oral Maxillofacial Surgery Permit, or Special Permit

Name: KHODAI, SHAHRAM

License/Registration Type: Dentist License

License Number: 43027 Primary Status: Current - Active

Address :
3517 Marconi Ave #105
SACRAMENTO CA 95821
SACRAMENTO COUNTY

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