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ExpiredCalifornia license 550804
License
- Licensed by
- Medical Board of California
- License number
- 550804
- Status
- Expired (Delinquent)
- First issued
- January 21, 2020
- Expired
- January 31, 2026
- Entity type
- Organization
Classifications
- Fictitious Name Permit Physicians & Surgeons
More from the license record
- License type code
- 8008
Contact
11423 Campus St
Loma Linda, CA 92354-3331
Loma Linda, CA 92354-3331
San Bernardino County