Indiana
Professional Licensing Agency
Fort Wayne Custom, Rx
Pharmacy Board - Csr Pharmacy
License number
60005855B
Date granted
08/30/2004
Date expires
12/31/2015
Class
Pharmacy Board - Csr Pharmacy
Status
Active
Address
425 E. Dupont Rd., Fort Wayne IN 46825
indianalicensing.org
ID 24883343
LAST UPDATED 2026-06-21 05:18:24 UTC
LAST UPDATED 2026-06-21 05:18:24 UTC
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