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Licensing details for: 79986

Name: HSIEH AND CHUNG DENTAL CORPORATION

License Type: Additional Office Permit

Primary Status: Current - Active

Organization Classification: Corporation

Address of Record

12455 VICTORIA GARDENS LANE #190
RANCHO CUCAMONGA CA 91739
SAN BERNARDINO county
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Practice Location

12455 VICTORIA GARDENS LANE #190
RANCHO CUCAMONGA CA 91739
SAN BERNARDINO county
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Issuance Date

February 15, 2019

Expiration Date

September 30, 2026

Current Date / Time

December 13, 2025
9:47:17 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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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, FREDERICK HYUN WOO

License/Registration Type: Dentist License

License Number: 43359 Primary Status: Current - Active

Address :
4000 W. FLORIDA AVE.
HEMET CA 92545
RIVERSIDE 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: CHUNG, SUSAN LEE

License/Registration Type: Dentist License

License Number: 64182 Primary Status: Current - Active

Address :
12455 Victoria Gardens Ln
Suite 190
RANCHO CUCAMONGA CA 91739-7530

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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: WATANABE, LYNDA CAROL

License/Registration Type: Dentist License

License Number: 40116 Primary Status: Current - Active

Address :
8715 Trautwein Rd
RIVERSIDE CA 92508-9474
RIVERSIDE 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: HSIEH, JOHN TUNG

License/Registration Type: Dentist License

License Number: 49759 Primary Status: Current - Active

Address :
5090 JUNEAU COURT
RANCHO CUCAMONGA CA 91739
SAN BERNARDINO COUNTY

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