CA Wall License 3413 Information
Name | John Ellis |
License Number | 3413 |
Individual or Organization | O |
Address | 191 Jefferson Drive Building #281 Menlo Park, CA 94025 |
County | San Mateo |
License Status | Active |
License Original Issue Date | 1/21/2004 |
License Expiration Date | 1/31/2023 |
License Type | Wall License |
Agency | Acupuncture Board |