Santa Rosa, CA
License renewed
Sep 22, 2025Expiration Date: 2025-09-30 2027-09-30
Workers Comp Effective Date: 2023-09-20 2025-09-21
Family support temporary license
Apr 17, 2025Family support temporary license
Sep 18, 2024License reinstated
Sep 21, 2023Primary Status: Family Sup Susp CLEAR
License renewed
Sep 21, 2023City: OAKLAND SANTA ROSA
County: Alameda Sonoma
Mailing Address: 8372 OUTLOOK AVENUE 5416 SHALLOWS PLACE W
ZIP Code: 94605 95409
Expiration Date: 2023-09-30 2025-09-30
Workers Comp Effective Date: 2021-09-24 2023-09-20
License issued
Sep 24, 2021