Licensee Name:HEALTH SERVICES AGENCY PHARMACY
License Type:RETAIL PHARMACY(FEE EXEMPT) BUSINESS LICENSE
License Number:20138
License Status:CLEAR Definition
Expiration Date:November 01, 2014
Issue Date:March 28, 2005
Address:830 SCENIC DR STE A
City:MODESTO
State:CA
Zip:95354
County:STANISLAUS
Actions:No
NumberNameTypeStatus
51719SHARAR STACIE LYNNREGISTERED PHARMACISTCLEAR

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