Dental Board of California
Licensing details for: 57041
Name: BALSHE, AYMAN ABDUL-LATIF
License Type: Dentist
Primary Status: Current - Active
Method of Application: Licensure by WREB
Secondary Status: Probation Terminated
Address of Record
12657 166th St
CERRITOS CA 90703-2101
LOS ANGELES county
Map
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: BLOOMFIELD DENTAL CENTER DENTAL OFFICE OF BALSHE DENTAL CORPORATION
License/Registration Type: Fictitious Name Permit
License Number: 18297 Primary Status: Current - Active
Address :
12657 E 166TH ST
CERRITOS CA 90703
LOS ANGELES COUNTY
