Licensee Name:CUSTOM CARE COMPOUNDING PHARMACY
License Type:LICENSED STERILE COMPOUNDING
License Number:99779
License Status:CANCELLED Definition
Expiration Date:October 01, 2013
Issue Date:October 31, 2012
Address:18080 SAN RAMON VALLEY BLVD #104
City:SAN RAMON
State:CA
Zip:94583
County:CONTRA COSTA
Actions:No
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