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Licensing details for: 4362

Name: MORAN, ALICE POLEY

License Type: Oral Conscious Sedation

Primary Status: Expired Primary Status Definition

Specialty: Adult

Address of Record

39788 Camino Michanito
INDIO CA 92203-4346
RIVERSIDE county
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Issuance Date

July 7, 2023

Expiration Date

January 31, 2025

Current Date / Time

June 6, 2025
7:29:23 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: MORAN, ALICE POLEY

License/Registration Type: Dentist License

License Number: 48514 Primary Status: Expired

Address :
39788 CAMINO MICHANITO
INDIO CA 92203
RIVERSIDE COUNTY

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