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ExpiredCalifornia license 556691
License
- Licensed by
- Medical Board of California
- License number
- 556691
- Status
- Expired (Delinquent)
- First issued
- November 22, 2023
- Expired
- November 30, 2025
- Entity type
- Organization
Classifications
- Fictitious Name Permit Physicians & Surgeons
More from the license record
- License type code
- 8008
Contact
6313 E Meritage Dr
Fresno, CA 93727-0974
Fresno, CA 93727-0974
Fresno County