Licensee Name:THEO LACY CORRECTIONAL FACILITY PHARMACY
License Type:LICENSED CORRECTIONAL FACILITY (FEE EXEMPT)
License Number:45678
License Status:CANCELLED Definition
Expiration Date:November 01, 2013
Issue Date:January 28, 2002
Address:501 CITY DRIVE SOUTH
City:ORANGE
State:CA
Zip:92868
County:ORANGE
Actions:No
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