CA Wall License 1470 Information
| Name | Kenny Phan |
| License Number | 1470 |
| Individual or Organization | O |
| Address | 504 S Brookhurst
Anaheim, CA 92804 |
| County | Orange |
| License Status | Active |
| License Original Issue Date | 9/30/2021 |
| License Expiration Date | 12/31/2023 |
| License Type | Wall License |
| Agency | Acupuncture Board |