Licensee Name:CORCORAN STATE PRISON HOSPITAL PHARMACY
License Type:LICENSED CORRECTIONAL FACILITY (FEE EXEMPT)
License Number:39334
License Status:CLEAR Definition
Expiration Date:November 01, 2015
Issue Date:May 20, 1993
Address:4001 KING AVE P O BOX 8800
City:CORCORAN
State:CA
Zip:93212
County:KINGS
Actions:No
NumberNameTypeStatus
55982MILLER BRYAN CHRISTOPHERREGISTERED PHARMACISTCLEAR
99298CORCORAN STATE PRISONGOVERNMENT OWNED PHARMACY OR HOSPITALCLEAR

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