CA Wall License 1179 Information
| Name | Kelly Krotine |
| License Number | 1179 |
| Individual or Organization | O |
| Address | 4910 Van Nuys Blvd, Suite 104
Sherman Oaks, CA 91403 |
| County | Los Angeles |
| License Status | Active |
| License Original Issue Date | 3/27/2012 |
| License Expiration Date | 6/30/2023 |
| License Type | Wall License |
| Agency | Acupuncture Board |