CA Wall License 1170 Information
Name | Erika Portnoy |
License Number | 1170 |
Individual or Organization | O |
Address | 4190 Bonita Road, Suite 103
Bonita, CA 91902 |
County | San Diego |
License Status | Active |
License Original Issue Date | 4/29/2016 |
License Expiration Date | 6/30/2023 |
License Type | Wall License |
Agency | Acupuncture Board |