Licensee Name:WALGREENS #07765
License Type:RETAIL PHARMACY
License Number:53023
License Status:CLEAR Definition
Expiration Date:May 22, 2015
Issue Date:December 31, 2014
Address:47900 WASHINGTON STREET
City:LA QUINTA
State:CA
Zip:92253
County:RIVERSIDE
Actions:No
NumberNameTypeStatus
41606CUSTODIO-PANGILINAN MA ADRIANA TRAJANOREGISTERED PHARMACISTCLEAR

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