Revive Spine Institute
ExpiredCalifornia license 552405
License
- Licensed by
- Medical Board of California
- License number
- 552405
- Status
- Expired (Delinquent)
- First issued
- April 1, 2021
- Expired
- April 30, 2023
- Entity type
- Organization
Classifications
- Fictitious Name Permit Physicians & Surgeons
More from the license record
- License type code
- 8008
Contact
220 Newport Center Dr # 11-282
Newport Beach, CA 92660-7506
Newport Beach, CA 92660-7506
Orange County