Last Updated:  12/21/2024 7:07:07 PM

Pharmacy Detail                               

Corporation / Company Owner Name

 

Business (DBA) Name  

EASTSIDE PHARMACY 

License Number 

3-8732 

Type of Pharmacy

Retail 

Address

3612 SE LEE BLVD

City, State, Zip 

LAWTON, OK  73501

Country 

 

Issue Date 

06/26/2020 

Renewed Date

06/24/2024

Expiration Date 

06/30/2025 

End Date 

 

Replacing

3-6455

Replaced By

Drug Supplier

Yes 

Sterile Compounding

No 

Training Area

Yes 

Unused Drug Dispensing

No 

LTC Emergency Kit

No

Pharmacist-In-Charge

JESSE WAYNE WILSON - 15439

Status

License in Good Standing 

In Process?

 

Disciplinary Action
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Case Date  

Case Number  

No Disciplinary Action 

 

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