Prudencio Banuelos Cisneros
ActiveCalifornia license 19712
License
- Licensed by
- California State Board of Pharmacy
- License number
- 19712
- Status
- Active
- First issued
- April 8, 2008
- Expires
- April 1, 2027
- License holder
- Prudencio Banuelos Cisneros
- Entity type
- Individual
Classifications
- Wls/mfg Designated Representative In Charge Pharmacy
More from the license record
- License type code
- EXC
- School
- Other/fg
- Year graduated
- 1988
- Degree
- Degree Not Applicable
Contact
27680 Mentry Ave
Valencia, CA 91355
Valencia, CA 91355
Los Angeles County