Licensee Name:MAMMOTH HOSPITAL PHARMACY
License Type:DRUG ROOM (FEE EXEMPT)
License Number:40421
License Status:CANCELLED Definition
Expiration Date:November 01, 2012
Issue Date:September 15, 1994
Address:85 SIERRA PARK ROAD
P O BOX 660
City:MAMMOTH LAKES
State:CA
Zip:93546
County:MONO
Actions:No
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