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Licensing details for: 18523

Name: COLLEGE STREET FAMILY DENTAL GROUP, EDISON S. HAN, DDS, INC.

License Type: Fictitious Name Permit

Primary Status: Current - Active

Organization Classification: Corporation

Address of Record

147 WEST COLLEGE STREET
COVINA CA 91723-2008
LOS ANGELES county
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Practice Location

147 WEST COLLEGE STREET
COVINA CA 91723-2008
LOS ANGELES county
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Issuance Date

April 15, 2024

Expiration Date

January 31, 2027

Current Date / Time

June 21, 2025
9:31:46 PM

License Relationships

FNP Owners

License/Registration Role: Fictitious Name Permit

Related Party Role: Owners

Name: HAN, EDISON SANGWOO

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: HAN, EDISON SANGWOO

License/Registration Type: Dentist License

License Number: 48608 Primary Status: Current - Active

Address :
153 W College St
COVINA CA 91723-2008
LOS ANGELES COUNTY

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