CA Wall License 1442 Information
Name | Russell Koester |
License Number | 1442 |
Individual or Organization | O |
Address | 1212 Farmers Lane, Suite 3
Santa Rosa, CA 95405 |
County | Sonoma |
License Status | Active |
License Original Issue Date | 5/21/2018 |
License Expiration Date | 9/30/2023 |
License Type | Wall License |
Agency | Acupuncture Board |