Licensee Name:KAISER PERMANENTE PHARMACY #401
License Type:LICENSED STERILE COMPOUNDING
License Number:99751
License Status:CLEAR Definition
Expiration Date:November 01, 2015
Issue Date:July 25, 2012
Address:5601 DE SOTO AVE BLDG 5 FL 4 RM 4891
City:WOODLAND HILLS
State:CA
Zip:91367-6701
County:LOS ANGELES
Actions:No
NumberNameTypeStatus
32997PROSSER DOUGLAS ALANREGISTERED PHARMACISTCLEAR
50964KAISER PERMANENTE PHARMACY #401RETAIL PHARMACYCLEAR

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