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ExpiredCalifornia license 557817
License
- Licensed by
- Medical Board of California
- License number
- 557817
- Status
- Expired (Delinquent)
- First issued
- July 30, 2024
- Expired
- July 31, 2026
- Entity type
- Organization
Classifications
- Fictitious Name Permit Physicians & Surgeons
More from the license record
- License type code
- 8008
Contact
1106 N La Cienega Blvd
Suite 206
West Hollywood, CA 90069-2493
Suite 206
West Hollywood, CA 90069-2493
Los Angeles County