Licensee Name:MODERN HEALTH PHARMACY
License Type:LICENSED STERILE COMPOUNDING
License Number:99266
License Status:CANCELLED Definition
Expiration Date:August 01, 2013
Issue Date:December 03, 2004
Address:110 E HUNTINGTON DR
City:MONROVIA
State:CA
Zip:91016
County:LOS ANGELES
Actions:No
NumberNameTypeStatus
44013MODERN HEALTH PHARMACYRETAIL PHARMACYCANCELLED

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