License Type:
Pharmacy
License Number:
5301004526
Organization Name:
FARMER JACK PHARMACIES INC #654
DBA Trade Name:
License Issue Date:
12/10/1986
License Expiration Date:
06/30/2007
License Status:
Lapsed
County:
Wayne
City:
Westland
State or Province:
Michigan
ZIP or Postal Code:
48185
CS Record Number:
5315181033
CS Status:
CS Expiration Date: