Revival Health Medical Group
ExpiredCalifornia license 553011
License
- Licensed by
- Medical Board of California
- License number
- 553011
- Status
- Expired (Delinquent)
- First issued
- August 17, 2021
- Expired
- August 31, 2023
- Entity type
- Organization
Classifications
- Fictitious Name Permit Physicians & Surgeons
More from the license record
- License type code
- 8008
Contact
4661 Wilshire Blvd Unit 105
Los Angeles, CA 90010-3931
Los Angeles, CA 90010-3931
Los Angeles County