Santa Rosa, CA
License data updated
Oct 22, 2025License data updated
Apr 9, 2025License renewed
Apr 8, 2025Mailing Address: 1001 MISSION BLVD APT 23 2303 BODIE ST
ZIP Code: 95409 95403
Expiration Date: 2025-05-31 2027-05-31
Workers' comp renewed
Oct 31, 2024Workers' comp suspension pending
Oct 22, 2024Secondary Status: WC Susp Pending
Workers' comp renewed
Oct 24, 2023License issued
Jun 29, 2013