CA Wall License 1068

CA Wall License 1068 Information

Name Dale Fanning
License Number1068
Individual or OrganizationO
Address1700 Shattuck Avenue
2nd Floor, Ste #2
Berkeley, CA 94709
CountyAlameda
License StatusActive
License Original Issue Date4/1/2014
License Expiration Date6/30/2023
License TypeWall License
AgencyAcupuncture Board