Licensee Name:KAISER PERMANENTE PHARMACY #221
License Type:LICENSED STERILE COMPOUNDING
License Number:99802
License Status:CLEAR Definition
Expiration Date:November 01, 2015
Issue Date:January 25, 2013
Address:4405 VANDEVER AVE FL 2
City:SAN DIEGO
State:CA
Zip:92120-3315
County:SAN DIEGO
Actions:No
NumberNameTypeStatus
51240KAISER PERMANENTE PHARMACY #221RETAIL PHARMACYCLEAR
69390DESAI MEGHA DIVAKERREGISTERED PHARMACISTCLEAR

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