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ActiveCalifornia license 554711
License
- Licensed by
- Medical Board of California
- License number
- 554711
- Status
- Active (Current)
- First issued
- September 27, 2022
- Expires
- September 30, 2028
- Entity type
- Organization
Classifications
- Fictitious Name Permit Physicians & Surgeons
More from the license record
- License type code
- 8008
Other California licenses under this name
-
CA
ActivePoway, CAExpires Nov 30, 2027
Contact
15706 Pomerado Rd # 5204
Poway, CA 92064-2067
Poway, CA 92064-2067
San Diego County