CA Wall License 3420

CA Wall License 3420 Information

Name Tracie Endelson
License Number3420
Individual or OrganizationO
Address2034 Lake Tahoe Blvd
South Lake Tahoe, CA 96150
CountyEl Dorado
License StatusActive
License Original Issue Date10/9/2017
License Expiration Date9/30/2023
License TypeWall License
AgencyAcupuncture Board