Licensee Name:CALIFORNIA INSTITUTE FOR MEN PHCY
License Type:HOSPITAL PHARMACY (FEE EXEMPT)
License Number:30781
License Status:CLEAR Definition
Expiration Date:November 01, 2015
Issue Date:December 01, 1984
Address:14901 SO CENTRAL AVE
City:CHINO
State:CA
Zip:91710
County:SAN BERNARDINO
Actions:No
NumberNameTypeStatus
54639BANGOU KERIM MREGISTERED PHARMACISTCLEAR
99144CALIFORNIA INSTITUTION FOR MENGOVERNMENT OWNED PHARMACY OR HOSPITALCANCELLED

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