Licensee Name:MEMORIAL MEDICAL CENTER OUTPATIENT PHARMACY
License Type:LICENSED STERILE COMPOUNDING
License Number:99980
License Status:CLEAR Definition
Expiration Date:November 01, 2015
Issue Date:June 19, 2014
Address:1800 COFFEE RD STE 110
City:MODESTO
State:CA
Zip:95356
County:STANISLAUS
Actions:No
NumberNameTypeStatus
33242MADSEN WILLIAM PETERREGISTERED PHARMACISTCLEAR
37596MEMORIAL MEDICAL CENTER OUTPATIENT PHARMACYHOSPITAL PHARMACY CLEAR

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