Licensee Name:VITHALANI DIVYA D
License Type:DESIGNATED REPRESENTATIVE
License Number:22615
License Status:CLEAR Definition
Expiration Date:April 01, 2016
Issue Date:April 22, 2014
Address:630 MAIN ST
City:BRAWLEY
State:CA
Zip:92227
County:IMPERIAL
Actions:No
NumberNameTypeStatus
6348AMERICAN PHARMA CORPWHOLESALERSCLEAR

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