Last Updated:  12/23/2024 5:22:52 AM

Pharmacy Detail                               

Corporation / Company Owner Name

 

Business (DBA) Name  

CHOCTAW NATION INDIAN HEALTH CLINIC PHCY 

License Number 

19-3887 

Type of Pharmacy

Retail 

Address

109 KERR AVE

City, State, Zip 

POTEAU, OK  74953-5231

Country 

 

Issue Date 

11/17/1994 

Renewed Date

08/25/2006

Expiration Date 

09/30/2007 

End Date 

04/05/2007 

Replacing

19-3830

Replaced By

19-5161

Drug Supplier

No 

Sterile Compounding

No 

Training Area

No 

Unused Drug Dispensing

No 

LTC Emergency Kit

No

Pharmacist-In-Charge

CANDICE L. VAUGHN - 13112

Status

CLOSED 

In Process?

 

Disciplinary Action
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Case Date  

Case Number  

No Disciplinary Action 

 

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