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Licensing details for: 3857

Name: PENG, WILLARD JAMES

License Type: Oral Conscious Sedation

Primary Status: Current - Active

Specialty: Adult

Previous Names: PENG, WILLARD J

Address of Record

30520 Rancho California Rd
Suite #A-105
TEMECULA CA 92591-3212
RIVERSIDE county
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Practice Location

440 S Melrose Dr
Suite 100
VISTA CA 92081-6680
SAN DIEGO county
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Issuance Date

March 4, 2019

Expiration Date

August 31, 2027

Current Date / Time

April 3, 2026
5:47:01 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: PENG, WILLARD JAMES

License/Registration Type: Dentist License

License Number: 59666 Primary Status: Current - Active

Address :
30520 Rancho California Rd
Suite #A-105
Suite#A-105
TEMECULA CA 92591-3212
RIVERSIDE COUNTY

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