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Licensing details for: 80044

Name: MICHAEL HOMAYUN DENTAL CORPORATION

License Type: Additional Office Permit

Primary Status: Cancelled

Organization Classification: Corporation

Address of Record

1531 6TH STREET #100
SANTA MONICA CA 90401
LOS ANGELES county
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Practice Location

1531 6TH STREET #100
SANTA MONICA CA 90401
LOS ANGELES county
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Issuance Date

April 22, 2019

Expiration Date

January 31, 2020

Current Date / Time

June 7, 2025
8:4:6 PM

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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