Licensee Name:PELICAN BAY STATE PRISON PHARMACY
License Type:LICENSED CORRECTIONAL FACILITY (FEE EXEMPT)
License Number:36228
License Status:CLEAR Definition
Expiration Date:November 01, 2015
Issue Date:March 21, 1990
Address:5905 LAKE EARL DRIVE
City:CRESCENT CITY
State:CA
Zip:95531
County:DEL NORTE
Actions:No
NumberNameTypeStatus
40000BEYERS GRACE MREGISTERED PHARMACISTCLEAR

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