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Active

California license 553664

License

Licensed by
Medical Board of California
License number
553664
Status
Active (Current)
First issued
February 11, 2022
Expires
February 29, 2028
Entity type
Organization

Classifications

More from the license record

License type code
8008

Contact

3800 Kilroy Airport Way Ste 100
Long Beach, CA 90806-6818
Los Angeles County