CA Wall License 1125 Information
| Name | Heather Shields |
| License Number | 1125 |
| Individual or Organization | O |
| Address | 99 Montecillo Road
San Rafael, CA 94903 |
| County | Marin |
| License Status | Active |
| License Original Issue Date | 9/15/2011 |
| License Expiration Date | 5/31/2023 |
| License Type | Wall License |
| Agency | Acupuncture Board |