CA Wall License 1170

CA Wall License 1170 Information

Name Erika Portnoy
License Number1170
Individual or OrganizationO
Address4190 Bonita Road, Suite 103
Bonita, CA 91902
CountySan Diego
License StatusActive
License Original Issue Date4/29/2016
License Expiration Date6/30/2023
License TypeWall License
AgencyAcupuncture Board