Coastal Functional Medicine
ExpiredCalifornia license 552002
License
- Licensed by
- Medical Board of California
- License number
- 552002
- Status
- Expired (Delinquent)
- First issued
- January 4, 2021
- Expired
- January 31, 2025
- Entity type
- Organization
Classifications
- Fictitious Name Permit Physicians & Surgeons
More from the license record
- License type code
- 8008
Contact
17800 Freitas Ln
Fort Bragg, CA 95437-8329
Fort Bragg, CA 95437-8329
Mendocino County