CA Wall License 1574 Information
Name | Theodore Lizee |
License Number | 1574 |
Individual or Organization | O |
Address | 325 E Hillcrest Drive, Suite 135
Thousand Oaks, CA 91360 |
County | Ventura |
License Status | Active |
License Original Issue Date | 11/20/2019 |
License Expiration Date | 8/31/2023 |
License Type | Wall License |
Agency | Acupuncture Board |