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Licensing details for: 4020

Name: NELSON, DAVID LYMAN

License Type: Oral Conscious Sedation

Primary Status: Cancelled

Specialty: Minor

Address of Record

3932 JEWELL ST APT N311
SAN DIEGO CA 92109
SAN DIEGO county
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Practice Location

10717 CAMINO RUIZ #103
SAN DIEGO CA 92126
SAN DIEGO county
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3257 CAMINO DE LOS COCHES SUITE 304
CARLSBAD CA 92009
SAN DIEGO county
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3440 DEL LAGO BLVD SUITE C
ESCONDIDO CA 92029
SAN DIEGO county
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520 BROADWAY #1
CHULA VISTA CA 91910
SAN DIEGO county
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Issuance Date

July 6, 2020

Expiration Date

May 31, 2022

Current Date / Time

June 6, 2025
2:17:8 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: NELSON, DAVID LYMAN

License/Registration Type: Dentist License

License Number: 103543 Primary Status: Current - Active

Address :
1005 W 38th St
#200
AUSTIN TX 78705-1041
TRAVIS COUNTY

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