Utah
Division of Occupational and Professional Licensing
PROVANTAGE PRESC MGT SERV
Pharmacy - Pharmacy Class D
License number
269542-1708
Date granted
02/22/1994
Date expires
05/31/1997
Class
Pharmacy - Pharmacy Class D
Status
Administrative Hold
Address
GREEN BAY, WI 54304
utahlicensing.org
ID 29881938
LAST UPDATED 2024-02-21 17:46:54 UTC
LAST UPDATED 2024-02-21 17:46:54 UTC
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