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Licensing details for: 5471

Name: SOO T PARK, DDS

License Type: Additional Office Permit

Primary Status: Cancelled

Organization Classification: Sole Owner

Address of Record

15165 7TH ST STE I
VICTORVILLE CA 92392
SAN BERNARDINO county
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Issuance Date

May 8, 1995

Expiration Date

August 31, 1999

Current Date / Time

December 13, 2025
11:39:2 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: PARK, SOO TAE

License/Registration Type: Dentist License

License Number: 33967 Primary Status: Current - Active

Address :
18011 MARABOU PLACE
CANYON COUNTRY CA 91387
LOS ANGELES COUNTY

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