Licensee Name:MODERN HEALTH PHARMACY - SD
License Type:LICENSED STERILE COMPOUNDING
License Number:99754
License Status:CLEAR Definition
Expiration Date:July 01, 2015
Issue Date:November 29, 2012
Address:13220 EVENING CREEK DR #109-110
City:SAN DIEGO
State:CA
Zip:92128
County:SAN DIEGO
Actions:No
NumberNameTypeStatus
51002MODERN HEALTH PHARMACY - SDRETAIL PHARMACYCLEAR
69548RECINTO PATRICK IRWIN KABIGTINGREGISTERED PHARMACISTCLEAR

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