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Licensing details for: 4237

Name: TRUONG, DAN THANH

License Type: Oral Conscious Sedation

Primary Status: Cancelled

Specialty: Minor

Address of Record

9185 DESIDERIO WAY
GILROY CA 95020
SANTA CLARA county
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Issuance Date

December 30, 2021

Expiration Date

September 30, 2023

Current Date / Time

June 6, 2025
10:20:7 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: TRUONG, DAN THANH

License/Registration Type: Dentist License

License Number: 102619 Primary Status: Current - Active

Address :
9185 Desiderio Way
GILROY CA 95020-9641
SANTA CLARA COUNTY

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