Back to Record|Export Record — SUB-2024-0038
Official Record

Civic Tide Licensing

State Regulatory Board · Submission Record

Reference Number
SUB-2024-0038
Exported April 15, 2026
Submission Type
Complaint
Category
Complaint
Current Status
Submitted

Submitter Information

Name
David Kim
Date Submitted
2024-04-04
License Number
LIC-2024-00123
Facility
Sunrise Wellness Center

Structured Narrative

Consumer reports receiving services from an individual who is not licensed by the board. Services were rendered on March 28, 2024. Consumer has provided receipts and communications as evidence.

This narrative was submitted directly by the licensee in a structured format. No reconstruction by staff was required.

Labeled Documents (2)

Document LabelFilenameLogged
Complaint Formconsumer_complaint_form.pdf2024-04-04 08:45
Supporting Evidencereceipts_evidence.pdf2024-04-04 08:45

Activity Timeline

Submission received
System · Apr 4, 2024 · 8:45 AM
Record Integrity

This record was generated from structured intake fields submitted through Civic Tide Licensing. No manual reconstruction was required. All documents are labeled as submitted.

Exported by
James Whitfield
Staff Reviewer
April 15, 2026

Civic Tide Licensing · State Regulatory Board · SUB-2024-0038 · Confidential