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Licensing details for: 13964

Name: EL PASEO DENTAL CENTER, DENTAL GROUP OF ANDREW LEE, DDS, INC.

License Type: Fictitious Name Permit

Primary Status: Current - Active

Organization Classification: Corporation

Address of Record

30212 TOMAS STE 165
RANCHO SANTA MARGARI CA 92688-2175
ORANGE county
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Practice Location

30212 TOMAS STE 165
RANCHO SANTA MARGARI CA 92688-2175
ORANGE county
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Issuance Date

January 2, 2018

Expiration Date

November 30, 2027

Current Date / Time

April 4, 2026
5:15:30 PM

License Relationships

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, ANDREW WONJOO

License/Registration Type: Dentist License

License Number: 49134 Primary Status: Current - Active

Address :
30212 TOMAS, SUITE 165
RANCHO SANTA MARGARI CA 92688
ORANGE COUNTY

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