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Licensing details for: 151

Name: CHAN, CHI LOK TIFFANY

License Type: Pediatric Minimal Sedation Permit

Primary Status: Current - Active

Previous Names: Chan, Chi Lok Tiffany

Address of Record

4210 BROOKE CT. UNIT 1006
SAN DIEGO CA 92122
SAN DIEGO county
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Practice Location

4072 ADAMS AVE.
SAN DIEGO CA 92116
SAN DIEGO county
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Issuance Date

September 21, 2023

Expiration Date

August 31, 2026

Current Date / Time

June 6, 2025
9:59:13 AM

License Relationships

PMS to DDS or OMS or SP

License/Registration Role: Pediatric Minimal Sedation Permit

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

Name: CHAN, CHI LOK TIFFANY

License/Registration Type: Dentist License

License Number: 106470 Primary Status: Current - Active

Address :
15835 Pomerado Rd
POWAY CA 92064-2073

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