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Licensing details for: 11010

Name: EKIZIAN AND ELIE DENTAL CORPORATION

License Type: Additional Office Permit

Primary Status: Current - Active

Organization Classification: Corporation

Address of Record

11850 1/2 BALBOA BLVD.
GRANADA HILLS CA 91344
LOS ANGELES county
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Practice Location

11850 1/2 BALBOA BLVD.
GRANADA HILLS CA 91344
LOS ANGELES county
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Issuance Date

May 2, 2013

Expiration Date

December 31, 2025

Current Date / Time

June 6, 2025
2:27:24 AM

License Relationships

AO to DDS or OMS (Owners)

License/Registration Role: Additional Office Permit

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

Name: WATANABE, BRYAN KAZUMI

License/Registration Type: Dentist License

License Number: 40130 Primary Status: Current - Active

Address :
40760 California Oaks Rd.
MURRIETA CA 92562
RIVERSIDE COUNTY

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