CA Wall License 3413

CA Wall License 3413 Information

Name John Ellis
License Number3413
Individual or OrganizationO
Address191 Jefferson Drive
Building #281
Menlo Park, CA 94025
CountySan Mateo
License StatusActive
License Original Issue Date1/21/2004
License Expiration Date1/31/2023
License TypeWall License
AgencyAcupuncture Board