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Expired

California license 556918

License

Licensed by
Medical Board of California
License number
556918
Status
Expired (Delinquent)
First issued
January 9, 2024
Expired
January 31, 2026
Entity type
Organization

Classifications

More from the license record

License type code
8008

Contact

23410 Civic Center Way Ste E7
Malibu, CA 90265-5917
Los Angeles County