Licensee Name:PRESTAB CO
License Type:NON RESIDENT PHARMACY
License Number:580
License Status:DELINQUENT Definition
Expiration Date:January 01, 2008
Issue Date:January 09, 2004
Address:3016 NW 79TH AVENUE
City:MIAMI
State:FL
Zip:33122
County:OUT OF STATE
Actions:No
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