CA Wall License 1659 Information
| Name | Shi Yan Xu |
| License Number | 1659 |
| Individual or Organization | O |
| Address | 206 E Las Tunas Drive #9
San Gabriel, CA 91776 |
| County | Los Angeles |
| License Status | Active |
| License Original Issue Date | 1/7/2014 |
| License Expiration Date | 1/31/2023 |
| License Type | Wall License |
| Agency | Acupuncture Board |