Licensee Name:LOS ANGELES CO SAN FERNANDO PHY
License Type:RETAIL PHARMACY(FEE EXEMPT) BUSINESS LICENSE
License Number:44724
License Status:CLEAR Definition
Expiration Date:November 01, 2015
Issue Date:March 02, 2000
Address:1212 PICO AVE
City:SAN FERNANDO
State:CA
Zip:91340
County:LOS ANGELES
Actions:No
NumberNameTypeStatus
41771KETRATANABORWORN BOONJEURREGISTERED PHARMACISTCLEAR

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