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Expired

California license 557143

License

Licensed by
Medical Board of California
License number
557143
Status
Expired (Delinquent)
First issued
February 28, 2024
Expired
February 28, 2026
Entity type
Organization

Classifications

More from the license record

License type code
8008

Contact

6850 Sepulveda Blvd Ste 210
Van Nuys, CA 91405-4446
Los Angeles County