Licensee Name:CUSTOM COMPOUNDING CENTERS LLC
License Type:LICENSED STERILE COMPOUNDING
License Number:99648
License Status:CLEAR Definition
Expiration Date:October 01, 2015
Issue Date:October 27, 2010
Address:10525 HUMBOLT STREET
City:LOS ALAMITOS
State:CA
Zip:90720
County:ORANGE
Actions:No
NumberNameTypeStatus
31207WHEELER PAUL ROBERTREGISTERED PHARMACISTCLEAR
46954CUSTOM COMPOUNDING CENTERS INCRETAIL PHARMACYCANCELLED
50368CUSTOM COMPOUNDING CENTERS LLCRETAIL PHARMACYCLEAR

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