Licensee Name:ELLSWORTH LYDIA ANN
License Type:PHARMACY TECHNICIAN
License Number:72762
License Status:CLEAR Definition
Expiration Date:July 31, 2016
Issue Date:October 27, 2006
Address:37222 FERBER DRIVE
City:RANCHO MIRAGE
State:CA
Zip:92270
County:RIVERSIDE
Actions:No
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