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Licensing details for: 3569

Name: DR LEE AND DR MUNOZ CHILDREN'S DENTAL

License Type: Fictitious Name Permit

Primary Status: Cancelled

Organization Classification: Partnership

Address of Record

1610 W EDINGER AVE, STE C
SANTA ANA CA 92704
ORANGE county
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Issuance Date

March 12, 2002

Expiration Date

August 31, 2005

Current Date / Time

June 7, 2025
7:5:20 AM

License Relationships

FNP Owners

License/Registration Role: Fictitious Name Permit

Related Party Role: Owners

Name: MUNOZ, NUMA FERNANDO

Address Not Disclosed

FNP Owners

License/Registration Role: Fictitious Name Permit

Related Party Role: Owners

Name: LEE, RICHARD SANG

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, RICHARD SANG

License/Registration Type: Dentist License

License Number: 44807 Primary Status: Current - Active

Address :
100 E VALENCIA MESA DR
Suite 102
FULLERTON CA 92835
ORANGE COUNTY

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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: MUNOZ, NUMA FERNANDO

License/Registration Type: Dentist License

License Number: 46894 Primary Status: Cancelled

Address :
7835 Lakeside Blvd Apt 946
BOCA RATON FL 33434-6265
PALM BEACH COUNTY

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