Last Updated: 12/22/2024 7:09:13 PM
Pharmacy
Detail
Corporation / Company Owner Name |
INNOVATION COMPOUNDING PHARMACY, LLC |
Business (DBA) Name |
INNOVATION COMPOUNDING |
License Number |
99-9108 |
Type of Pharmacy |
Non-Resident |
Address |
6095 PINE MOUNTAIN RD NW STE 108 |
City, State, Zip |
KENNESAW,
GA 30152 |
Country |
|
Issue Date |
12/21/2021 |
Renewed Date |
11/22/2024 |
Expiration Date |
12/31/2025 |
End Date |
|
Replacing |
|
Replaced By |
|
Drug Supplier |
No |
Sterile Compounding |
Yes |
Training Area |
No |
Unused Drug Dispensing |
No |
LTC Emergency Kit |
No |
Pharmacist-In-Charge |
THOMAS BRADLEY LEDBETTER - 19998 |
Status |
License in Good Standing |
In Process? |
|
|
|
|
Disciplinary Action
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that column.
No Disciplinary
Action |
|
|