Charlton Lane Long
ActiveCalifornia license 22472
License
- Licensed by
- California State Board of Pharmacy
- License number
- 22472
- Status
- Active
- First issued
- November 15, 2013
- Expires
- November 1, 2027
- License holder
- Charlton Lane Long
- 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
- 2011
- Degree
- Degree Not Applicable
Contact
3000 Mark Lv Pkw
Fort Worth, TX 76106
Fort Worth, TX 76106