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Licensing details for: 79940

Name: E. KIM DENTAL CORPORATION

License Type: Additional Office Permit

Primary Status: Expired Primary Status Definition

Organization Classification: Corporation

Address of Record

11201 CALIFORNIA STREET #D
REDLANDS CA 92373
SAN BERNARDINO county
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Practice Location

11201 CALIFORNIA STREET #D
REDLANDS CA 92373
SAN BERNARDINO county
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Issuance Date

December 19, 2018

Expiration Date

September 30, 2022

Current Date / Time

December 13, 2025
7:54:30 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: KIM, EUGENIE HEO

License/Registration Type: Dentist License

License Number: 62603 Primary Status: Current - Active

Address :
62 SWIFT
IRVINE CA 92618-1705
ORANGE COUNTY

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