Last Updated:  5/2/2024 7:07:06 PM

Pharmacy Detail                               

Corporation / Company Owner Name

 

Business (DBA) Name  

MED-X DRUG NO. 04 

License Number 

2-5465 

Type of Pharmacy

Retail 

Address

4423 SOUTHWEST BLVD

City, State, Zip 

TULSA, OK  74107-6472

Country 

 

Issue Date 

08/10/2009 

Renewed Date

12/06/2012

Expiration Date 

11/30/2013 

End Date 

03/27/2013 

Replacing

2-193

Replaced By

2-6235

Drug Supplier

No 

Sterile Compounding

No 

Training Area

No 

Unused Drug Dispensing

No 

LTC Emergency Kit

No

Pharmacist-In-Charge

KYLE DAVID KEENUM - 14574

Status

CLOSED 

In Process?

 

Disciplinary Action
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Case Date  

Case Number  

No Disciplinary Action 

 

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