CA Licensed Acupuncturist 18103

CA Licensed Acupuncturist 18103 Information

NameNirada Phaphant
License Number18103
Individual or OrganizationI
Address1101 Ocean Front Walk Apt 503
Venice, CA 90291
CountyLos Angeles
License StatusActive
License Original Issue Date5/24/2018
License Expiration Date4/30/2024
License TypeLicensed Acupuncturist
AgencyAcupuncture Board
SchoolYosan University Of Tcm