Centenarian
ActiveCalifornia license 557191
License
- Licensed by
- Medical Board of California
- License number
- 557191
- Status
- Active (Current)
- First issued
- March 7, 2024
- Expires
- March 31, 2028
- Entity type
- Organization
Classifications
- Fictitious Name Permit Physicians & Surgeons
More from the license record
- License type code
- 8008
Contact
4311 Wilshire Blvd Ste 400
Los Angeles, CA 90010-3713
Los Angeles, CA 90010-3713
Los Angeles County