Dental Board of California
Licensing details for: 212
Name: KIM, JIN WAN
License Type: Moderate Sedation Permit
Primary Status: Cancelled
Secondary Status: Canceled at Request of Licensee
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: KIM, JIN WAN
License/Registration Type: Dentist License
License Number: 103133 Primary Status: Current - Active
Address :
408 Hillsborough Blvd
SAN MATEO CA 94402-1126
SAN MATEO COUNTY
