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Expired

California license 553602

License

Licensed by
Medical Board of California
License number
553602
Status
Expired (Delinquent)
First issued
January 19, 2022
Expired
January 31, 2024
Entity type
Organization

Classifications

More from the license record

License type code
8008

Contact

1610 Blossom Hill Rd Ste 3B
San Jose, CA 95124-6349
Santa Clara County