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Licensing details for: 12027

Name: BADII LEE DENTAL CORPORATION, INC.

License Type: Additional Office Permit

Primary Status: Cancelled

Organization Classification: Corporation

Address of Record

1109 W 17TH STREET
SANTA ANA CA 92706
ORANGE county
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Practice Location

1109 W 17TH STREET
SANTA ANA CA 92706
ORANGE county
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Issuance Date

September 29, 2015

Expiration Date

July 31, 2016

Current Date / Time

June 7, 2025
11:59:53 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: BADII, KIAVASH KEVIN

License/Registration Type: Dentist License

License Number: 54538 Primary Status: Current - Active

Address :
1424 S Euclid St
FULLERTON CA 92832-3152
ORANGE COUNTY

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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: LEE, DANIEL HARVEY

License/Registration Type: Dentist License

License Number: 56861 Primary Status: Current - Active

Address :
14252 Culver Dr
Suite 831
IRVINE CA 92604-0317
ORANGE COUNTY

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