Licensee Name:OLDE TYME PHARMACY
License Type:NON RESIDENT PHARMACY
License Number:218
License Status:CANCELLED Definition
Expiration Date:November 01, 1998
Issue Date:November 07, 1996
Address:3013 RIGEL AVENUE
City:LAS VEGAS
State:NV
Zip:89102
County:OUT OF STATE
Actions:No
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