CA Wall License 883 Information
Name | Mark Fishman |
License Number | 883 |
Individual or Organization | O |
Address | 249 Entrada Drive 249 Entrada Drive Santa Monica, CA 90402 |
County | Los Angeles |
License Status | Active |
License Original Issue Date | 1/20/2000 |
License Expiration Date | 3/31/2023 |
License Type | Wall License |
Agency | Acupuncture Board |