CA Wall License 1067

CA Wall License 1067 Information

Name Dale Fanning
License Number1067
Individual or OrganizationO
Address1335 Standford Avenue
Emeryville, CA 94608
CountyAlameda
License StatusActive
License Original Issue Date4/1/2014
License Expiration Date6/30/2023
License TypeWall License
AgencyAcupuncture Board