Dental Board of California
Licensing details for: 12136
Name: GARDENS DENTAL SPA, DENTAL PRACTICE OF DR. KEUN LEE
License Type: Fictitious Name Permit
Primary Status: Cancelled
Organization Classification: Corporation
Previous Names: PRACTICE OF KEUN LEE ❖ GARDENS DENTAL SPA, PRACTICE OF DR. KEUN LEE
Address of Record
12531 EAST CARSON STREET
HAWAIIAN GARDENS CA 90716
LOS ANGELES county
Map
License Relationships
FNP Owners
License/Registration Role: Fictitious Name Permit
Related Party Role: Owners
Name: LEE, KEUN CHAN
Address Not Disclosed
FNP to DDS or OMS
License/Registration Role: Fictitious Name Permit
Related Party Role: Must hold an active Dental License, or Oral Maxillofacial Surgery Permit
Name: LEE, KEUN CHAN
License/Registration Type: Dentist License
License Number: 49928 Primary Status: Current - Active
Address :
8581 MONTICELLO AVE
BUENA PARK CA 90621
ORANGE COUNTY
