License holder summary

EATHERLY ADELINE T is a Pharmacy - Designated Representative (Exemptees) licensed to practice in California. The address on file for EATHERLY ADELINE T is 798 N CONEY AVENUE AZUSA CA 91702. This licensed professional license is not current. The license was granted 06/09/2004 and expired on 06/01/2011.

California

Department of Consumer Affairs

EATHERLY ADELINE T
Pharmacy - Designated Representative (Exemptees)
License number
17494
Date granted
06/09/2004
Date expires
06/01/2011
Class
Pharmacy - Designated Representative (Exemptees)
Status
Canceled
Address
798 N CONEY AVENUE AZUSA CA 91702
californialicensing.org
ID 11665370
LAST UPDATED 2024-03-08 15:26:23 UTC

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