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Licensing details for: 50

Name: SMITH, GREGORY EDWARD

License Type: Moderate Sedation Permit

Primary Status: Cancelled

Address of Record

31876 DEL OBISPO ST. STE 103
SAN JUAN CAPISTRANO CA 92675
ORANGE county
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Practice Location

31876 DEL OBISPO ST. STE 103
SAN JUAN CAPISTRANO CA 92675
ORANGE county
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Issuance Date

December 16, 2022

Expiration Date

September 26, 2023

Current Date / Time

June 6, 2025
2:1:54 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: SMITH, GREGORY EDWARD

License/Registration Type: Dentist License

License Number: 53873 Primary Status: Current - Active

Address :
9339 Genesee Ave
Suite 150
SAN DIEGO CA 92121-2119
SAN DIEGO COUNTY

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