Licensee Name:ELLISON TERA ANCHESTONIQU
License Type:PHARMACY TECHNICIAN
License Number:40856
License Status:CANCELLED Definition
Expiration Date:July 31, 2011
Issue Date:February 08, 2002
Address:6650 INDIANA AVE #4
City:LONG BEACH
State:CA
Zip:90805
County:LOS ANGELES
Actions:No
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