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Licensing details for: 155

Name: WELCH, EILEEN LEE

License Type: Moderate Sedation Permit

Primary Status: Cancelled

Qualification: Pediatric Endorsement Under 13 Pediatric Endorsement Under 7Primary Status Definition

Previous Names: WELCH, EILEEN L

Address of Record

10717 LAWLER STREET APT 203
LOS ANGELES CA 90034
LOS ANGELES county
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Practice Location

12930 VENTURA BVLD #226
STUDIO CITY CA 91604
LOS ANGELES county
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Issuance Date

May 18, 2023

Expiration Date

July 10, 2024

Current Date / Time

June 6, 2025
10:19:7 AM

License Relationships

MS to DDS or OMS or SP

License/Registration Role: Moderate Sedation Permit

Related Party Role: Must hold an active Dental License, Oral Maxillofacial Surgery Permit, or Special Permit

Name: WELCH, EILEEN LEE

License/Registration Type: Dentist License

License Number: 64806 Primary Status: Current - Active

Address :
535 e desert willow road
LOS ANGELES CA 90034-5497
LOS ANGELES COUNTY

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