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Active

California license 555963

License

Licensed by
Medical Board of California
License number
555963
Status
Active (Current)
First issued
June 22, 2023
Expires
June 30, 2027
Entity type
Organization

Classifications

More from the license record

License type code
8008

Contact

8130 Brookhollow Ct
Loomis, CA 95650-8049
Placer County