CA Wall License 883

CA Wall License 883 Information

Name Mark Fishman
License Number883
Individual or OrganizationO
Address249 Entrada Drive
249 Entrada Drive
Santa Monica, CA 90402
CountyLos Angeles
License StatusActive
License Original Issue Date1/20/2000
License Expiration Date3/31/2023
License TypeWall License
AgencyAcupuncture Board