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Licensing details for: A 204243

Name: Lee, Jae Han

License Type: Physician and Surgeon A

Primary Status: License Renewed & Current Primary Status Definition

School Name: Loyola University of Chicago Stritch School of Medicine

Graduation Year: 2024

Address of Record

4445 Magnolia Ave
RIVERSIDE CA 92501-4135
RIVERSIDE county
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Issuance Date

July 29, 2025

Expiration Date

September 30, 2027

Current Date / Time

April 3, 2026
3:38:38 AM

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License Relationships

Postgraduate Training License associated with Physician & Surgeon License

License/Registration Role: Physician & Surgeon

Related Party Role: Postgraduate Training License

Name: Lee, Jae Han

License/Registration Type: Postgraduate Training License

License Number: 16116 Primary Status: License Canceled

Address :
4510 Brockton Ave Ste 262
RIVERSIDE CA 92501-4015
RIVERSIDE COUNTY

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Survey Information

The following information is self-reported by the licensee and has not been verified by the Board.

No AB 133 Survey Information Provided by Licensee

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