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Licensing details for: 81022

Name: SHIN & LEE DDS, INC

License Type: Additional Office Permit

Primary Status: Current - Active

Organization Classification: Corporation

Address of Record

3150 E IMPERIAL HWY, B8-207
LYNWOOD CA 90262
LOS ANGELES county
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Practice Location

3150 E IMPERIAL HWY, B8-207
LYNWOOD CA 90262
LOS ANGELES county
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Issuance Date

August 31, 2021

Expiration Date

December 31, 2025

Current Date / Time

June 21, 2025
9:53:6 PM

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: SHIN, SANG GYU

License/Registration Type: Dentist License

License Number: 59863 Primary Status: Current - Active

Address :
12625 Frederick St
Suite F-4
MORENO VALLEY CA 92553-5216
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: LEE, GUNDONG

License/Registration Type: Dentist License

License Number: 65092 Primary Status: Current - Active

Address :
1235 N HARBOR BLVD, STE 100
FULLERTON CA 92832
ORANGE COUNTY

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