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Expired

California license 554621

License

Licensed by
Medical Board of California
License number
554621
Status
Expired (Delinquent)
First issued
September 15, 2022
Expired
September 30, 2024
Entity type
Organization

Classifications

More from the license record

License type code
8008

Contact

1501 Superior Ave Ste 300
Newport Beach, CA 92663-3641
Orange County