Last Updated: 12/5/2025 5:24:46 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 |
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|
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 |
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In Process? |
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Disciplinary Action
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that column.
|
03/30/2022 |
1635 |
|
Contact Board for more information. |
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