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Licensing details for: 358

Name: TUCKER, BRENT ARLENTON

License Type: Pediatric Minimal Sedation Permit

Primary Status: Current - Active

Address of Record

13412 Inglewood Ave
HAWTHORNE CA 90250-5603
LOS ANGELES county
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Issuance Date

September 26, 2024

Expiration Date

September 30, 2026

Current Date / Time

June 6, 2025
1:59:29 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: TUCKER, BRENT ARLENTON

License/Registration Type: Dentist License

License Number: 65354 Primary Status: Current - Active

Address :
13412 Inglewood Ave
HAWTHORNE CA 90250-5603
LOS ANGELES COUNTY

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