CA Wall License 411 Information
Name | Marisa Puente |
License Number | 411 |
Individual or Organization | O |
Address | 2900 Bristol St Building G, Suite 106 Costa Mesa, CA 92626 |
County | Orange |
License Status | Active |
License Original Issue Date | 4/8/2021 |
License Expiration Date | 1/31/2024 |
License Type | Wall License |
Agency | Acupuncture Board |