Ag ProVision LLC - (Drug Distributor)
Miles Edwin Stocker, MIC
Kenansville, MO 28349
License# : 2012010650 - Issued on : 4/3/2012
Doing Business As : Ag ProVision LLC
| Licensee Name: | Ag ProVision LLC |
| Profession Name: | Drug Distributor |
| Licensee Number: | 2012010650 |
| Expiration Date: | 10/31/2017 |
| Original Issue Date: | 4/3/2012 |
| Address: | Miles Edwin Stocker, MIC |
| Address Con't: | 227 Faison McGowan Rd |
| City, State Zip: | Kenansville, NC 28349 |
| County: | Unknown/Out of State |
| Practitioner DBA Name: | Ag ProVision LLC |
| Classification: | Out of State Wholesale |
| 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
