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Licensing details for: 7510

Name: SAMUEL KO, DDS

License Type: Additional Office Permit

Primary Status: Cancelled

Organization Classification: Sole Owner

Address of Record

4654 EAST AVENUE "S" SUITE A
PALMDALE CA 93552
LOS ANGELES county
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Issuance Date

September 17, 2001

Expiration Date

September 30, 2004

Current Date / Time

December 13, 2025
9:49:15 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: KO, SAMUEL HYUNWOOK

License/Registration Type: Dentist License

License Number: 40454 Primary Status: Current - Active

Address :
12429 MARIPOSA RD. SUITE A
VICTORVILLE CA 92395
SAN BERNARDINO COUNTY

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