Licensee Name:MOUNTAINS COMMUNITY HOSPITAL PHARMACY
License Type:LICENSED STERILE COMPOUNDING
License Number:100505
License Status:CLEAR Definition
Expiration Date:September 01, 2015
Issue Date:June 18, 2014
Address:29101 HOSPITAL ROAD
PO BOX 70
City:LAKE ARROWHEAD
State:CA
Zip:92352
County:SAN BERNARDINO
Actions:No
NumberNameTypeStatus
29555CRAWFORD DANIEL GUYREGISTERED PHARMACISTCLEAR
36642MOUNTAINS COMMUNITY HOSPITAL PHARMACYHOSPITAL PHARMACY CLEAR

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