PROVANTAGE PRESC MGT SERV
Pharmacy - Dispensing Controlled Substance License
Utah 269542-8913 Administrative Hold
This Utah license was held by PROVANTAGE PRESC MGT SERV. The license is no longer active. It was granted on 02/22/1994 and expired on 05/31/1997
LICENSE DETAILS
- License Number: 269542-8913
- Category: DISPENSING CONTROLLED SUBSTANCE LICENSE
- Status: Administrative Hold
- Date Granted: 02/22/1994 (over 32 years ago)
- Expiry Date: 05/31/1997 (about 29 years ago)
LOCATIONS
A Address
GREEN BAY, WI 54304