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Licensing details for: 18104

Name: SIGNATURE ENDODONTICS DENTAL OFFICE OF SAMUEL H. IP DDS

License Type: Fictitious Name Permit

Primary Status: Current - Active

Organization Classification: Corporation

Address of Record

30212 TOMAS #210
RANCHO SANTA MARGARI CA 92688
ORANGE county
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Practice Location

30212 TOMAS #210
RANCHO SANTA MARGARI CA 92688
ORANGE county
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Issuance Date

September 15, 2023

Expiration Date

December 31, 2026

Current Date / Time

June 6, 2025
9:59:37 AM

License Relationships

FNP Owners

License/Registration Role: Fictitious Name Permit

Related Party Role: Owners

Name: IP, SAMUEL HO-SHUN

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: IP, SAMUEL HO-SHUN

License/Registration Type: Dentist License

License Number: 47734 Primary Status: Current - Active

Address :
30212 TOMAS #210
RANCHO SANTA MARGAR CA 92688
ORANGE COUNTY

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