Vacaville, CA
License renewed
Oct 27, 2025City: FAIRFIELD VACAVILLE
Mailing Address: 706 BROADWAY #E 1042 FRESHWATER COURTHOME
ZIP Code: 94533 95687
Expiration Date: 2025-09-30 2027-09-30
Workers Comp Effective Date: 2023-09-20 2025-10-25
License data updated
Jul 23, 2025License renewed
Sep 27, 2023City: BURLINGAME FAIRFIELD
County: San Mateo Solano
Mailing Address: 120 LORTON AVE APT 6 706 BROADWAY #E
ZIP Code: 94010 94533
Expiration Date: 2023-09-30 2025-09-30
Workers Comp Effective Date: 2021-09-29 2023-09-20
Renewal received
Sep 23, 2023License issued
Apr 6, 1979