Nlwla
ExpiredCalifornia license 557997
License
- Licensed by
- Medical Board of California
- License number
- 557997
- Status
- Expired (Delinquent)
- First issued
- August 27, 2024
- Expired
- August 31, 2026
- Entity type
- Organization
Classifications
- Fictitious Name Permit Physicians & Surgeons
More from the license record
- License type code
- 8008
Contact
11965 Venice Blvd Ste 407
Los Angeles, CA 90066-3982
Los Angeles, CA 90066-3982
Los Angeles County