Licensee Name:CUSTOM COMPOUNDING CENTERS INC
License Type:LICENSED STERILE COMPOUNDING
License Number:99274
License Status:CANCELLED Definition
Expiration Date:November 01, 2010
Issue Date:December 24, 2004
Address:12062 VALLEY VIEW ST #140
City:GARDEN GROVE
State:CA
Zip:92845
County:ORANGE
Actions:No
NumberNameTypeStatus
46954CUSTOM COMPOUNDING CENTERS INCRETAIL PHARMACYCANCELLED

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