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Active

California license 555649

License

Licensed by
Medical Board of California
License number
555649
Status
Active (Current)
First issued
April 19, 2023
Expires
April 30, 2027
Entity type
Organization

Classifications

More from the license record

License type code
8008

Contact

1530 Baker St Ste A
Costa Mesa, CA 92626-3752
Orange County