License Directory

Modmd

Active

California license 551697

License

Licensed by
Medical Board of California
License number
551697
Status
Active (Current)
First issued
October 14, 2020
Expires
October 31, 2028
Entity type
Organization

Classifications

More from the license record

License type code
8008

Contact

208 Lincoln Blvd
Venice, CA 90291-2810
Los Angeles County