Licensee Name:FAIRMONT HOSPITAL
License Type:HOSPITAL PHARMACY (FEE EXEMPT)
License Number:2787
License Status:CANCELLED Definition
Expiration Date:November 01, 1996
Issue Date:November 01, 1984
Address:15400 FOOTHILL BLVD
City:SAN LEANDRO
State:CA
Zip:94577
County:ALAMEDA
Actions:No
NumberNameTypeStatus
38835IWATSU KERRY DEANREGISTERED PHARMACISTCLEAR

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