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Licensing details for: 4515

Name: MYLAD, BOTAMENA M

License Type: Oral Conscious Sedation

Primary Status: Current - Active

Specialty: Adult

Address of Record

24119 Hemlock Ave
Ste 108
MORENO VALLEY CA 92557-7220
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Issuance Date

October 22, 2024

Expiration Date

October 31, 2026

Current Date / Time

December 13, 2025
9:20:14 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: MYLAD, BOTAMENA M

License/Registration Type: Dentist License

License Number: 103690 Primary Status: Current - Active

Address :
24119 Hemlock Ave
STE 108
MORENO VALLEY CA 92557-7220
RIVERSIDE COUNTY

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