Licensee Name:UCLA 16TH STREET PHARMACY
License Type:RETAIL PHARMACY(FEE EXEMPT) BUSINESS LICENSE
License Number:50897
License Status:CLEAR Definition
Expiration Date:November 01, 2015
Issue Date:March 14, 2012
Address:1223 SIXTEENTH ST RM 1202
City:SANTA MONICA
State:CA
Zip:90404
County:LOS ANGELES
Actions:No
NumberNameTypeStatus
100497UCLA 16TH ST. PHARMACYGOVERNMENT OWNED PHARMACY OR HOSPITALCLEAR
57643OKUMYANSKY YEVGENYREGISTERED PHARMACISTCLEAR

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