Licensee Name:KAISER PERMANENTE PHARMACY #162
License Type:LICENSED STERILE COMPOUNDING
License Number:99362
License Status:CLEAR Definition
Expiration Date:November 01, 2015
Issue Date:February 06, 2006
Address:9961 SIERRA AVE MOB 3 BASEMENT
City:FONTANA
State:CA
Zip:92335-6720
County:SAN BERNARDINO
Actions:No
NumberNameTypeStatus
33139FONG ELIZABETH EVAREGISTERED PHARMACISTCLEAR
47314KAISER PERMANENTE PHARMACY #162RETAIL PHARMACYCLEAR

Comments