Licensee Name:MED 4 HOME PHARMACY
License Type:NON RESIDENT PHARMACY
License Number:342
License Status:CANCELLED Definition
Expiration Date:December 01, 2001
Issue Date:December 23, 1999
Address:340 S 291 HWY
City:LIBERTY
State:MO
Zip:64068
County:OUT OF STATE
Actions:No
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