Last Updated: 12/22/2024 5:22:09 AM
Pharmacy
Detail
Corporation / Company Owner Name |
|
Business (DBA) Name |
CUSTOMCEUTICAL COMPOUNDING, LLC |
License Number |
99-6467 |
Type of Pharmacy |
Non-Resident |
Address |
4611 E SHEA BLVD, STE 180 |
City, State, Zip |
PHOENIX,
AZ 85028 |
Country |
|
Issue Date |
10/23/2013 |
Renewed Date |
11/13/2018 |
Expiration Date |
10/31/2019 |
End Date |
10/31/2019 |
Replacing |
|
Replaced By |
|
Drug Supplier |
No |
Sterile Compounding |
No |
Training Area |
No |
Unused Drug Dispensing |
No |
LTC Emergency Kit |
No |
Pharmacist-In-Charge |
SARAH KATHRYN SIMMERS - 17365 |
Status |
CLOSED |
In Process? |
|
|
|
|
Disciplinary Action
Click on any of the Underlined headings to sort by
that column.
No Disciplinary
Action |
|
|