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ExpiredCalifornia license 551876
License
- Licensed by
- Medical Board of California
- License number
- 551876
- Status
- Expired (Delinquent)
- First issued
- November 17, 2020
- Expired
- November 30, 2022
- Entity type
- Organization
Classifications
- Fictitious Name Permit Physicians & Surgeons
More from the license record
- License type code
- 8008
Contact
1935 Addison St Ste A
Berkeley, CA 94704-1354
Berkeley, CA 94704-1354
Alameda County