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Licensing details for: 11657

Name: MICHAEL HOMAYUN DENTAL CORPORATION

License Type: Additional Office Permit

Primary Status: Cancelled

Organization Classification: Corporation

Address of Record

4648 LANKERSHIM BLVD
NORTH HOLLYWOOD CA 91602
LOS ANGELES county
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Practice Location

4648 LANKERSHIM BLVD
NORTH HOLLYWOOD CA 91602
LOS ANGELES county
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Issuance Date

January 12, 2015

Expiration Date

January 31, 2020

Current Date / Time

December 13, 2025
9:49:58 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: HOMAYUN, MICHAEL

License/Registration Type: Dentist License

License Number: 37838 Primary Status: Current - Active

Address :
18511 Sherman Way
RESEDA CA 91335-4213
LOS ANGELES COUNTY

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