CA Wall License 1273 Information
Name | Cheng Guang Shi |
License Number | 1273 |
Individual or Organization | O |
Address | 1186 Los Altos Ave
Los Altos, CA 94022 |
County | Santa Clara |
License Status | Active |
License Original Issue Date | 8/31/2021 |
License Expiration Date | 9/30/2023 |
License Type | Wall License |
Agency | Acupuncture Board |