Travis Lane Stork
ExpiredCalifornia license A105482
License
- Licensed by
- Medical Board of California
- License number
- A105482
- Status
- Expired (Delinquent)
- First issued
- September 5, 2008
- Expired
- March 31, 2022
- License holder
- Travis Lane Stork
- Entity type
- Individual
Classifications
- Physician and Surgeon A Physicians & Surgeons
More from the license record
- License type code
- 8002
Contact
Mae West Bldg 2nd Flr
5555 Melrose Avenue
Los Angeles, CA 90038
5555 Melrose Avenue
Los Angeles, CA 90038
Los Angeles County