Functional Medicine
ExpiredCalifornia license 42654
License
- Licensed by
- Medical Board of California
- License number
- 42654
- Status
- Expired (Delinquent)
- First issued
- March 30, 2012
- Expired
- March 31, 2022
- Entity type
- Organization
Classifications
- Fictitious Name Permit Physicians & Surgeons
More from the license record
- License type code
- 8008
Contact
8367 Beverly Blvd
Los Angeles, CA 90048-2633
Los Angeles, CA 90048-2633
Los Angeles County