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Expired

California license 546403

License

Licensed by
Medical Board of California
License number
546403
Status
Expired (Delinquent)
First issued
September 1, 2016
Expired
September 30, 2026
Entity type
Organization

Classifications

More from the license record

License type code
8008

Contact

16 Carisbrook Ln
Oakland, CA 94611-1614
Alameda County