Dental Board of California
Licensing details for: 13781
Name: OAK GROVE DENTAL GROUP, WATANABE AND LYNN PROFESSIONAL DENTAL CORPORATION
License Type: Fictitious Name Permit
Primary Status: Cancelled
Organization Classification: Corporation
License Relationships
FNP Owners
License/Registration Role: Fictitious Name Permit
Related Party Role: Owners
Name: DO YABUT, DIANA SONG
Address Not Disclosed
FNP Owners
License/Registration Role: Fictitious Name Permit
Related Party Role: Owners
Name: LYNN, STEVEN CHRISTOPHER
Address Not Disclosed
FNP Owners
License/Registration Role: Fictitious Name Permit
Related Party Role: Owners
Name: WATANABE, BRYAN KAZUMI
Address Not Disclosed
FNP Owners
License/Registration Role: Fictitious Name Permit
Related Party Role: Owners
Name: LEE, FREDERICK HYUN WOO
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: LYNN, STEVEN CHRISTOPHER
License/Registration Type: Dentist License
License Number: 48505 Primary Status: Current - Active
Address :
29273 Central Ave
Suite A
LAKE ELSINORE CA 92532
RIVERSIDE COUNTY
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: WATANABE, BRYAN KAZUMI
License/Registration Type: Dentist License
License Number: 40130 Primary Status: Current - Active
Address :
40760 California Oaks Rd.
MURRIETA CA 92562
RIVERSIDE COUNTY
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, 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
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: DO YABUT, DIANA SONG
License/Registration Type: Dentist License
License Number: 53903 Primary Status: Current - Active
Address :
20201 CHIANTI COURT
YORBA LINDA CA 92886
ORANGE COUNTY
