On-Site Physical Certifications
ActiveCalifornia license 552156
License
- Licensed by
- Medical Board of California
- License number
- 552156
- Status
- Active (Current)
- First issued
- February 3, 2021
- Expires
- February 28, 2027
- Entity type
- Organization
Classifications
- Fictitious Name Permit Physicians & Surgeons
More from the license record
- License type code
- 8008
Contact
1715 42nd Ave Ste B
Capitola, CA 95010-3557
Capitola, CA 95010-3557
Santa Cruz County