Insoo Song
ExpiredCalifornia license 104475
License
- Licensed by
- Dental Board of California
- License number
- 104475
- Status
- Expired (Delinquent)
- First issued
- October 4, 2019
- Expired
- July 31, 2022
- License holder
- Insoo Song
- Entity type
- Individual
Classifications
- Dental License Dental
More from the license record
- License type code
- 4401
Contact
5144 Balmoral Ct.
Grand Prairie, TX 75052
Grand Prairie, TX 75052
Dallas County