Prive Medicine La
ExpiredCalifornia license 557372
License
- Licensed by
- Medical Board of California
- License number
- 557372
- Status
- Expired (Delinquent)
- First issued
- April 19, 2024
- Expired
- April 30, 2026
- Entity type
- Organization
Classifications
- Fictitious Name Permit Physicians & Surgeons
More from the license record
- License type code
- 8008
Contact
1809 Washington Way
Venice, CA 90291-4703
Venice, CA 90291-4703
Los Angeles County