Licensee Name:LASSEN INDIAN HEALTH CENTER PHARMACY
License Type:RETAIL PHARMACY(FEE EXEMPT) BUSINESS LICENSE
License Number:47046
License Status:CLEAR Definition
Expiration Date:November 01, 2015
Issue Date:February 16, 2005
Address:795 JOAQUIN ST
City:SUSANVILLE
State:CA
Zip:96130
County:LASSEN
Actions:No
NumberNameTypeStatus
28291GILMER VERNA RAEREGISTERED PHARMACISTCLEAR

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