Licensee Name:KARBKAEW KAMOLPAN
License Type:PHARMACY TECHNICIAN
License Number:59661
License Status:CANCELLED Definition
Expiration Date:December 31, 2010
Issue Date:November 24, 2004
Address:5535 ESMOND AVE
City:RICHMOND
State:CA
Zip:94805
County:CONTRA COSTA
Actions:No
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