State of California Department of Public Health (CALDPH)
Medical License
Validity Period End: 2025-08-31
Validity Period Start: 2020-08-31
Issued Date: 2025-11-13
Credential Number: 0
License Number: 123456
Licensing State: California
Instructor Name: Dr. John Smith
Holder: 0x78C36136F9fc3f405B3Ae99eB6c6781116093351