The Modern Woman, A Division of Bass Medical Group
ExpiredCalifornia license 554187
License
- Licensed by
- Medical Board of California
- License number
- 554187
- Status
- Expired (Delinquent)
- First issued
- June 9, 2022
- Expired
- June 30, 2024
- Entity type
- Organization
Classifications
- Fictitious Name Permit Physicians & Surgeons
More from the license record
- License type code
- 8008
Contact
990 Sonoma Ave Ste 18
Santa Rosa, CA 95404-4813
Santa Rosa, CA 95404-4813
Sonoma County