CA Wall License 3304 Information
| Name | Ellen Lazares |
| License Number | 3304 |
| Individual or Organization | O |
| Address | 33315 Santiago Road
Acton, CA 93510 |
| County | Los Angeles |
| License Status | Active |
| License Original Issue Date | 9/21/1989 |
| License Expiration Date | 6/30/2024 |
| License Type | Wall License |
| Agency | Acupuncture Board |