CA Wall License 3470 Information
Name | Tara Diaz |
License Number | 3470 |
Individual or Organization | O |
Address | 519 Main Street
El Segundo, CA 90245 |
County | Los Angeles |
License Status | Active |
License Original Issue Date | 8/22/2022 |
License Expiration Date | 9/30/2024 |
License Type | Wall License |
Agency | Acupuncture Board |