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 |