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Licensing details for: 17161

Name: ROSENBLUM, ALVIN B

License Type: Dentist

Primary Status: Cancelled

Secondary Status: Reduced Renewal Fee Radiation Safety Certification

Address of Record

2930 NEILSON WAY 3-308
SANTA MONICA CA 90405
LOS ANGELES county
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Issuance Date

January 1, 1963

Expiration Date

July 31, 2016

Current Date / Time

April 3, 2026
6:59:44 PM

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: WLA DENTAL CENTER, GROUP OF ALVIN B ROSENBLUM DDS

License/Registration Type: Fictitious Name Permit

License Number: 1036 Primary Status: Cancelled

Address :
AND ABDOLREZA SAMENI DDS
1950 SAWTELLE BLVD STE 100
LOS ANGELES CA 90025
LOS ANGELES COUNTY

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