CA Wall License 2097

CA Wall License 2097 Information

Name Susan Shane
License Number2097
Individual or OrganizationO
Address17530 Via Del Bravo
Rancho Santa Fe, CA 92067
CountySan Diego
License StatusActive
License Original Issue Date9/6/1994
License Expiration Date2/29/2024
License TypeWall License
AgencyAcupuncture Board