CA Wall License 1397

CA Wall License 1397 Information

Name Gregory Lane
License Number1397
Individual or OrganizationO
Address162 S Rancho Santa Fe Road, #a30
Encinitas, CA 92024
CountySan Diego
License StatusActive
License Original Issue Date9/7/1994
License Expiration Date7/31/2024
License TypeWall License
AgencyAcupuncture Board