Licensee Name:MERCY MEDICAL CENTER MT SHASTA MAIN PHARMACY - FIRST FLOOR
License Type:LICENSED STERILE COMPOUNDING
License Number:100091
License Status:CLEAR Definition
Expiration Date:March 01, 2016
Issue Date:May 17, 2014
Address:914 PINE STREET
City:MT SHASTA
State:CA
Zip:96067
County:SISKIYOU
Actions:No
NumberNameTypeStatus
45527MERCY MEDICAL CENTER MT SHASTAHOSPITAL PHARMACY CLEAR
65605CODIANNE NATALIE GRACEREGISTERED PHARMACISTCLEAR

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