TX Licensed Acupuncturist 18282

TX Licensed Acupuncturist 18282 Information

NameKenneth Grant Mittelstadt
License Number18282
Individual or OrganizationI
Address8088 Old Austin Rd
Ste 2a
Selma, TX 78154
License StatusActive
License Original Issue Date12/5/2018
License Expiration Date12/31/2023
License TypeLicensed Acupuncturist
AgencyAcupuncture Board
SchoolSouthern California University Of Health Sciences