Last Updated: 12/5/2025 7:08:18 PM
Pharmacy
Detail
|
Corporation / Company Owner Name |
|
|
Business (DBA) Name |
DRUG WAREHOUSE NO. 11 |
|
License Number |
36-4013 |
|
Type of Pharmacy |
Retail |
|
Address |
905 S MUSKOGEE AVE STE C |
|
City, State, Zip |
TAHLEQUAH,
OK 74464-4731 |
|
Country |
|
|
Issue Date |
03/28/1996 |
|
Renewed Date |
11/10/2009 |
|
Expiration Date |
11/30/2010 |
|
End Date |
03/24/2010 |
|
Replacing |
|
|
Replaced By |
|
|
Drug Supplier |
No |
|
Sterile Compounding |
No |
|
Training Area |
No |
|
Unused Drug Dispensing |
No |
|
LTC Emergency Kit |
No |
|
Pharmacist-In-Charge |
RICHARD KENT HANSEN - 10558 |
|
Status |
CLOSED |
|
In Process? |
|
|
|
|
|
|
|
Disciplinary Action
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that column.
|
No Disciplinary
Action |
|