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Licensing details for: 15120

Name: PARK BLVD ORAL SURGERY DENTAL OFFICE OF S. STEVEN PODSTRELENY, DDS, PC

License Type: Fictitious Name Permit

Primary Status: Cancelled

Organization Classification: Corporation

Address of Record

4067 PARK BLVD
SAN DIEGO CA 92103
SAN DIEGO county
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Practice Location

4067 PARK BLVD
SAN DIEGO CA 92103
SAN DIEGO county
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Issuance Date

July 11, 2019

Expiration Date

October 31, 2020

Current Date / Time

April 3, 2026
7:37:01 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: PODSTRELENY, STEVEN S

License/Registration Type: Dentist License

License Number: 50861 Primary Status: Current - Active

Address :
4067 Park Blvd
SAN DIEGO CA 92103-2619
SAN DIEGO COUNTY

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