Divino
ExpiredCalifornia license 554400
License
- Licensed by
- Medical Board of California
- License number
- 554400
- Status
- Expired (Delinquent)
- First issued
- August 3, 2022
- Expired
- August 31, 2024
- Entity type
- Organization
Classifications
- Fictitious Name Permit Physicians & Surgeons
More from the license record
- License type code
- 8008
Contact
180 Otay Lakes Rd # 103110
Bonita, CA 91902-2443
Bonita, CA 91902-2443
San Diego County