Licensee Name:KAISER PERMANENTE PHARMACY #377
License Type:LICENSED STERILE COMPOUNDING
License Number:100395
License Status:CLEAR Definition
Expiration Date:November 01, 2015
Issue Date:June 25, 2014
Address:1190 VETERANS BLVD
CYPRESS BLDG FL2 RM 110
City:REDWOOD CITY
State:CA
Zip:94063-2037
County:SAN MATEO
Actions:No
NumberNameTypeStatus
51925KAISER PERMANENTE PHARMACY #377RETAIL PHARMACYCLEAR
59672TANG TERRILL TUNG-LOONEREGISTERED PHARMACISTCLEAR

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