License Number: PS15501

Data As Of 2/7/2023

Profession Pharmacist
License PS15501
License Status NULL AND VOID/
License Expiration Date 7/31/1997
License Original Issue Date 10/13/1976
Address of Record If further information is needed, please contact the Department of Health at (850) 488-0595.
Discipline on File No
Public Complaint No

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