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ExpiredCalifornia license 553134
License
- Licensed by
- Medical Board of California
- License number
- 553134
- Status
- Expired (Delinquent)
- First issued
- September 16, 2021
- Expired
- September 30, 2023
- Entity type
- Organization
Classifications
- Fictitious Name Permit Physicians & Surgeons
More from the license record
- License type code
- 8008
Contact
1652 Camino Del Rio N # FS21
San Diego, CA 92108-1514
San Diego, CA 92108-1514
San Diego County