Licensee Name:MARTIN LUTHER KING JR MACC OUTPT PHY
License Type:RETAIL PHARMACY(FEE EXEMPT) BUSINESS LICENSE
License Number:14222
License Status:CLEAR Definition
Expiration Date:November 01, 2015
Issue Date:August 04, 2004
Address:12021 S WILMINGTON AVE RM 1086
City:LOS ANGELES
State:CA
Zip:90059
County:LOS ANGELES
Actions:No
NumberNameTypeStatus
32283DUNN NATHANIEL CHING-LIANGREGISTERED PHARMACISTCLEAR
99465MARTIN LUTHER KING JR-HARBOR HOSPITALGOVERNMENT OWNED PHARMACY OR HOSPITALCANCELLED

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