Licensee Name:CUSTOM COMPOUNDING CENTERS
License Type:LICENSED STERILE COMPOUNDING
License Number:99047
License Status:CANCELLED Definition
Expiration Date:October 01, 2005
Issue Date:July 01, 2003
Address:12062 VALLEY VIEW ST #140
City:GARDEN GROVE
State:CA
Zip:92845
County:ORANGE
Actions:No
NumberNameTypeStatus
46133CUSTOM COMPOUNDING CENTERS INCRETAIL PHARMACYCANCELLED

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