License holder summary

KELAITA DEREK MARTIN is a Pharmacy - Designated Representative (Exemptees) licensed to practice in California. The address on file for KELAITA DEREK MARTIN is 12555 HIGH BLUFF DR STE 300 SAN DIEGO CA 92130. This licensed professional license is not current. The license was granted 12/06/2010 and expired on 12/01/2011.

California

Department of Consumer Affairs

KELAITA DEREK MARTIN
Pharmacy - Designated Representative (Exemptees)
License number
21012
Date granted
12/06/2010
Date expires
12/01/2011
Class
Pharmacy - Designated Representative (Exemptees)
Status
Canceled
Address
12555 HIGH BLUFF DR STE 300 SAN DIEGO CA 92130
californialicensing.org
ID 11671502
LAST UPDATED 2026-07-04 15:24:58 UTC

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