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Licensing details for: 3765

Name: ENTABI, KHALED

License Type: Oral Conscious Sedation

Primary Status: Expired Primary Status Definition

Specialty: Adult

Address of Record

2600 S TRACY BLVD
TRACY CA 95376
SAN JOAQUIN county
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Practice Location

2600 S TRACY BLVD, SUITE 170
TRACY CA 95376
SAN JOAQUIN county
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Issuance Date

May 4, 2018

Expiration Date

December 31, 2023

Current Date / Time

December 13, 2025
2:3:42 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: ENTABI, KHALED

License/Registration Type: Dentist License

License Number: 56401 Primary Status: Current - Active

Address :
2600 S TRACY BL
STE 170
TRACY CA 95376
SAN JOAQUIN COUNTY

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