CA Wall License 2184 Information
Name | Kenneth Phelps |
License Number | 2184 |
Individual or Organization | O |
Address | 101 The City Drive South Building 56, Suite 800, Room 831 Orange, CA 92868 |
County | Orange |
License Status | Active |
License Original Issue Date | 1/18/2022 |
License Expiration Date | 2/29/2024 |
License Type | Wall License |
Agency | Acupuncture Board |