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Licensing details for: 4442

Name: ANDERSON, SHAWN RAY

License Type: Oral Conscious Sedation

Primary Status: Current - Active

Specialty: Adult

Address of Record

25109 JEFFERSON AVE. SUITE 220
MURRIETA CA 92562
RIVERSIDE county
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Practice Location

25109 JEFFERSON AVE. SUITE 220
MURRIETA CA 92562
RIVERSIDE county
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Issuance Date

March 5, 2024

Expiration Date

October 31, 2027

Current Date / Time

December 13, 2025
11:40:11 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: ANDERSON, SHAWN RAY

License/Registration Type: Dentist License

License Number: 57725 Primary Status: Current - Active

Address :
25109 JEFFERSON AVE, SUITE 220
MURRIETA CA 92562
RIVERSIDE COUNTY

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