CA Wall License 1067 Information
Name | Dale Fanning |
License Number | 1067 |
Individual or Organization | O |
Address | 1335 Standford Avenue
Emeryville, CA 94608 |
County | Alameda |
License Status | Active |
License Original Issue Date | 4/1/2014 |
License Expiration Date | 6/30/2023 |
License Type | Wall License |
Agency | Acupuncture Board |