Family Pharmacy of Missouri LLC - (Pharmacy)
Kristi Van Etten, PIC
Bolivar, MO 65613
License# : 2006014908 - Issued on : 5/31/2006
Doing Business As : Family Pharmacy #20
| Licensee Name: | Family Pharmacy of Missouri LLC |
| Profession Name: | Pharmacy |
| Licensee Number: | 2006014908 |
| Expiration Date: | 10/31/2015 |
| Original Issue Date: | 5/31/2006 |
| Address: | Kristi Van Etten, PIC |
| Address Con't: | 1326 W. Broadway |
| City, State Zip: | Bolivar, MO 65613 |
| County: | Polk |
| Practitioner DBA Name: | Family Pharmacy #20 |
| Classification: | Class A, C, J |
| Current Discipline Status: | None |
Board of Pharmacy
3605 Missouri Boulevard
P.O. Box 625
Jefferson City, MO 65102-0625
573.751.0091 Telephone
573.526.3464 Fax
800.735.2966 TTY
800.735.2466 Voice Relay
MissouriBOP@pr.mo.gov
http://pr.mo.gov/pharmacists
