Licensee Name:BASCOM WHOLESALE LLC
License Type:WHOLESALERS
License Number:5490
License Status:CANCELLED Definition
Expiration Date:May 01, 2012
Issue Date:May 20, 2010
Address:105 N BASCOM AVE STE 100
City:SAN JOSE
State:CA
Zip:95128-1811
County:SANTA CLARA
Actions:No
NumberNameTypeStatus
43998FULLER CLIVE ALEXANDERREGISTERED PHARMACISTCLEAR

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