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Licensing details for: 1163

Name: SOROUR, SELVANA

License Type: Oral Conscious Sedation

Primary Status: Cancelled

Specialty: Minor

Address of Record

13340 HAWTHORNE BLVD
HAWTHORNE CA 90250
LOS ANGELES county
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Issuance Date

March 19, 2007

Expiration Date

November 30, 2023

Current Date / Time

December 13, 2025
5:39:3 PM

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: SOROUR, SELVANA

License/Registration Type: Dentist License

License Number: 54394 Primary Status: Current - Active

Address :
13340 HAWTHORNE BLVD
HAWTHORNE CA 90250
LOS ANGELES COUNTY

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