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Licensing details for: 16170

Name: NELA ORTHODONTICS DENTAL GROUP OF PETER LEE DDS, MS

License Type: Fictitious Name Permit

Primary Status: Current - Active

Organization Classification: Corporation

Address of Record

4867 EAGLE ROCK BOULEVARD., SUITE B
LOS ANGELES CA 90041
LOS ANGELES county
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Practice Location

4867 EAGLE ROCK BOULEVARD., SUITE B
LOS ANGELES CA 90041
LOS ANGELES county
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Issuance Date

December 9, 2020

Expiration Date

October 31, 2025

Current Date / Time

June 6, 2025
1:29:36 PM

License Relationships

FNP Owners

License/Registration Role: Fictitious Name Permit

Related Party Role: Owners

Name: LEE, PETER BYUNG 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, PETER BYUNG CHAN

License/Registration Type: Dentist License

License Number: 100072 Primary Status: Current - Active

Address :
4867 Eagle Rock Blvd
Suite B
LOS ANGELES CA 90041-2657
LOS ANGELES COUNTY

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