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Licensing details for: 813

Name: GHOTANIAN, RENE

License Type: Conscious Sedation

Primary Status: Cancelled

Address of Record

5363 Balboa Blvd Ste 346
ENCINO CA 91316-2836
LOS ANGELES county
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Issuance Date

September 10, 2012

Expiration Date

June 30, 2024

Current Date / Time

June 6, 2025
9:47:51 AM

License Relationships

CS to DDS, OMS, or SP

License/Registration Role: Conscious Sedation Permit

Related Party Role: Must hold an active Dental License, Oral Maxillofacial Surgery Permit, or Special Permit

Name: GHOTANIAN, RENE

License/Registration Type: Dentist License

License Number: 42824 Primary Status: Current - Active

Address :
5363 Balboa Blvd Ste 346
ENCINO CA 91316-2836
LOS ANGELES COUNTY

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