California
Department of Consumer Affairs
MORRIS PROVIDENCE DISTEFANO
Registered Pharmacist
License number
44588
Date granted
08/16/1991
Date expires
03/31/2015
Class
Registered Pharmacist
Status
Canceled
Address
3150 GOLDFINCH STREET SAN DIEGO CA 92103
californialicensing.org
ID 12154994
LAST UPDATED 2024-02-29 17:28:04 UTC
LAST UPDATED 2024-02-29 17:28:04 UTC
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