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Licensing details for: 11206

Name: JOHN HSIEH DENTAL CORPORATION

License Type: Additional Office Permit

Primary Status: Cancelled

Organization Classification: Corporation

Secondary Status: Cancelled at the Request of the LicenseePrimary Status Definition

Address of Record

7319 MILLIKEN AVENUE SUITE 110
RANCHO CUCAMONGA CA 91730
SAN BERNARDINO county
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Practice Location

7319 MILLIKEN AVENUE SUITE 110
RANCHO CUCAMONGA CA 91730
SAN BERNARDINO county
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Issuance Date

September 18, 2013

Expiration Date

May 31, 2019

Current Date / Time

December 13, 2025
9:49:52 AM

License Relationships

AO to DDS or OMS (Owners)

License/Registration Role: Additional Office Permit

Related Party Role: Must hold an active Dental License, or Oral Maxillofacial Surgery Permit

Name: REAGAN, DARIN SCOTT

License/Registration Type: Dentist License

License Number: 34407 Primary Status: Current - Active

Address :
943 AVENIDA PICO, STE. A
SAN CLEMENTE CA 92673
ORANGE COUNTY

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