Second to Creation
ActiveCalifornia license 544716
License
- Licensed by
- Medical Board of California
- License number
- 544716
- Status
- Active (Current)
- First issued
- April 29, 2015
- Expires
- April 30, 2027
- Entity type
- Organization
Classifications
- Fictitious Name Permit Physicians & Surgeons
More from the license record
- License type code
- 8008
Contact
4550 Ontario Mills Pkwy Ste 107
Ontario, CA 91764
Ontario, CA 91764
San Bernardino County