Licensee Name:MARK TWAIN MEDICAL CENTER
License Type:HOSPITAL PHARMACY
License Number:36219
License Status:CLEAR Definition
Expiration Date:March 01, 2016
Issue Date:March 20, 1990
Address:768 MOUNTAIN RANCH ROAD
City:SAN ANDREAS
State:CA
Zip:95249
County:CALAVERAS
Actions:No
NumberNameTypeStatus
40969ORTIZ JILL DEENAREGISTERED PHARMACISTCLEAR
99975MARK TWAIN MEDICAL CENTER PHARMACYLICENSED STERILE COMPOUNDINGCLEAR

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