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Licensing details for: 8196

Name: EDWIN O BARZALLO, DDS, INC

License Type: Additional Office Permit

Primary Status: Cancelled

Organization Classification: Corporation

Address of Record

871 SOUTH ATLANTIC BLVD
MONTEREY PARK CA 91754
LOS ANGELES county
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Issuance Date

February 9, 2004

Expiration Date

November 30, 2006

Current Date / Time

June 6, 2025
8:35:6 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: BARZALLO, EDWIN O

License/Registration Type: Dentist License

License Number: 49467 Primary Status: Current - Active

Address :
741 S Atlantic Blvd
LOS ANGELES CA 90022-3213
LOS ANGELES COUNTY

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