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Licensing details for: 128

Name: NGUYEN, JUSTIN LEE

License Type: Oral Maxillofacial Surgery

Primary Status: Current - Active

Address of Record

1251 E Imperial Hwy
PLACENTIA CA 92870-1718
ORANGE county
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Issuance Date

March 30, 2021

Expiration Date

November 30, 2025

Current Date / Time

June 7, 2025
7:23:39 AM

License Relationships

GA to DDS or OMS or SP

License/Registration Role: Must hold an active Dental License, Oral Maxillofacial Surgery Permit, or Special Permit

Related Party Role: General Anesthesia Permit

Name: NGUYEN, JUSTIN LEE

License/Registration Type: General Anesthesia Permit

License Number: 2032 Primary Status: Current - Active

Address :
1251 E Imperial Hwy
PLACENTIA CA 92870-1718
ORANGE COUNTY

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