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Licensing details for: 106457

Name: AMIR KHAN, ALI

License Type: Dentist

Primary Status: Current - Active

Method of Application: Licensure by WREB

Address of Record

1862 S Bentley Ave
303
LOS ANGELES CA 90025-4374
LOS ANGELES county
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Practice Location

1140 S Robertson Blvd
1
LOS ANGELES CA 90035-1457
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Issuance Date

July 3, 2021

Expiration Date

September 30, 2026

Current Date / Time

December 13, 2025
11:33:14 AM

License Relationships

FNP to DDS or OMS

License/Registration Role: Must hold an active Dental License, or Oral Maxillofacial Surgery Permit

Related Party Role: Fictitious Name Permit

Name: LA DENTAL BOUTIQUE AMIRKHAN DENTAL PRACTICE CORPORATION

License/Registration Type: Fictitious Name Permit

License Number: 17461 Primary Status: Current - Active

Address :
1140 S. ROBERTSON BLVD STE 1
LOS ANGELES CA 90035
LOS ANGELES COUNTY

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