Licensee Name:KAISER PERMANENTE PHARMACY #252
License Type:LICENSED STERILE COMPOUNDING
License Number:100630
License Status:CLEAR Definition
Expiration Date:November 01, 2015
Issue Date:July 18, 2014
Address:13652 CANTARA ST, BLDG 5, RM L21
City:PANORAMA CITY
State:CA
Zip:91402-5423
County:LOS ANGELES
Actions:No
NumberNameTypeStatus
43673JAMGOTCHIAN DIANAREGISTERED PHARMACISTCLEAR
51937KAISER PERMANENTE PHARMACY #252RETAIL PHARMACYCLEAR

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