Mdiom
ExpiredCalifornia license 39713
License
- Licensed by
- Medical Board of California
- License number
- 39713
- Status
- Expired (Delinquent)
- First issued
- January 20, 2010
- Expired
- January 31, 2024
- Entity type
- Organization
Classifications
- Fictitious Name Permit Physicians & Surgeons
More from the license record
- License type code
- 8008
Contact
28212 Kelly Johnson Pkwy Ste 215
Valencia, CA 91355-5090
Valencia, CA 91355-5090
Los Angeles County