Dental Board of California
Licensing details for: 81412
Name: DENTAL CORPORATION OF JASON LEE
License Type: Additional Office Permit
Primary Status: Cancelled
Organization Classification: Corporation
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: JEONG, DONG JUN
License/Registration Type: Dentist License
License Number: 61931 Primary Status: Current - Active
Address :
10910 OLSEN DR. SUITE 100
RANCHO CORDOVA CA 95670
SACRAMENTO COUNTY
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: BAUTISTA, REYMOND CARBONELL
License/Registration Type: Dentist License
License Number: 56217 Primary Status: Current - Active
Address :
1221 Albright Walk
SACRAMENTO CA 95818-1682
SACRAMENTO COUNTY
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: GILL, AMARDEEP KAUR
License/Registration Type: Dentist License
License Number: 50464 Primary Status: Current - Active
Address :
1450 E Main St
Ste 100
WOODLAND CA 95776-6201
YOLO COUNTY
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: MOKBIL, AHMAD
License/Registration Type: Dentist License
License Number: 101058 Primary Status: Current - Active
Address :
1016 Riley St
1
1016 Riley St
FOLSOM CA 95630-3265
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, JASON SANGJAE
License/Registration Type: Dentist License
License Number: 100095 Primary Status: Current - Active
Address :
10910 Olson Dr
Ste 100
RANCHO CORDOVA CA 95670-5643
SACRAMENTO COUNTY
