License holder summary

FANTY RANDOLPH V is a Pharmacy - Designated Representative (Exemptees) licensed to practice in California. The address on file for FANTY RANDOLPH V is 11010 HOPKINS STREET UNIT C MIRA LOMA CA 91752. This licensed professional license is not current. The license was granted 09/03/1999 and expired on 09/01/2002.

California

Department of Consumer Affairs

FANTY RANDOLPH V
Pharmacy - Designated Representative (Exemptees)
License number
15137
Date granted
09/03/1999
Date expires
09/01/2002
Class
Pharmacy - Designated Representative (Exemptees)
Status
Canceled
Address
11010 HOPKINS STREET UNIT C MIRA LOMA CA 91752
californialicensing.org
ID 11669159
LAST UPDATED 2026-04-28 15:23:12 UTC

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