Licensee Name:KAISER PERMANENTE PHARMACY #171
License Type:LICENSED STERILE COMPOUNDING
License Number:99251
License Status:CLEAR Definition
Expiration Date:November 01, 2015
Issue Date:July 07, 2004
Address:2295 S VINEYARD AVE
City:ONTARIO
State:CA
Zip:91761-7922
County:SAN BERNARDINO
Actions:No
NumberNameTypeStatus
32018SALAS MANUEL JOSEREGISTERED PHARMACISTCLEAR
46811KAISER PERMANENTE PHARMACY #171RETAIL PHARMACYCLEAR

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