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Licensing details for: 12956

Name: GREAT EXPRESSION DENTAL, OFFICE OF LAMISE KASSEM D.D.S

License Type: Fictitious Name Permit

Primary Status: Current - Active

Organization Classification: Corporation

Address of Record

17482 Irvine Blvd Ste D
TUSTIN CA 92780-3032
ORANGE county
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Practice Location

17482 IRVINE BLVD, SUITE D
TUSTIN CA 92780
ORANGE county
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Issuance Date

July 5, 2016

Expiration Date

January 31, 2027

Current Date / Time

June 6, 2025
10:9:4 AM

License Relationships

FNP Owners

License/Registration Role: Fictitious Name Permit

Related Party Role: Owners

Name: KASSEM, LAMISE G

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: KASSEM, LAMISE G

License/Registration Type: Dentist License

License Number: 51269 Primary Status: Current - Active

Address :
23211 COFFEEBERRY CIRCLE
CORONA CA 92883
RIVERSIDE COUNTY

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