Licensee Name:CUSTOM PRESCRIPTIONS
License Type:NONRESIDENT STERILE COMPOUNDING
License Number:99748
License Status:CANCELLED Definition
Expiration Date:May 01, 2014
Issue Date:May 16, 2012
Address:1200 112TH AVE NE STE A102
City:BELLEVUE
State:WA
Zip:98004
County:OUT OF STATE
Actions:No
NumberNameTypeStatus
1226CUSTOM PRESCRIPTIONSNON RESIDENT PHARMACY CLEAR

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