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Licensing details for: 4225

Name: DUONG, VI-KHOI KYLE

License Type: Oral Conscious Sedation

Primary Status: Cancelled

Specialty: Minor

Address of Record

1443 Deer Hollow Dr
CORONA CA 92882-6069
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Practice Location

250 S G St
SAN BERNARDINO CA 92410-3320
SAN BERNARDINO county
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Issuance Date

December 28, 2021

Expiration Date

September 30, 2023

Current Date / Time

June 6, 2025
10:5:16 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: DUONG, VI-KHOI KYLE

License/Registration Type: Dentist License

License Number: 104550 Primary Status: Current - Active

Address :
1643 S San Jacinto Ave
Ste 100 and 101
SAN JACINTO CA 92583-5181

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