Last Updated: 12/23/2024 5:22:52 AM
Pharmacy
Detail
Corporation / Company Owner Name |
|
Business (DBA) Name |
THACKERVILLE PHARMACY LLC |
License Number |
72-5917 |
Type of Pharmacy |
Retail |
Address |
11530 RIDGE RD, STE 1 |
City, State, Zip |
THACKERVILLE,
OK 73459-9623 |
Country |
|
Issue Date |
03/07/2012 |
Renewed Date |
03/17/2021 |
Expiration Date |
03/31/2022 |
End Date |
03/30/2022 |
Replacing |
|
Replaced By |
|
Drug Supplier |
No |
Sterile Compounding |
No |
Training Area |
No |
Unused Drug Dispensing |
No |
LTC Emergency Kit |
No |
Pharmacist-In-Charge |
DIANE MICHELE ROWE-BOND - 11910 |
Status |
Revoked |
In Process? |
|
|
|
|
Disciplinary Action
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that column.
03/30/2022 |
1635 |
Contact Board for more information. |
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