AmerisourceBergen Drug Corporation - (Drug Distributor)
Frank DiCenso, MIC
Lockbourne, MO 43137
License# : 2004028337 - Issued on : 9/30/2004
Doing Business As : AmerisourceBergen Drug Corporation
| Licensee Name: | AmerisourceBergen Drug Corporation |
| Profession Name: | Drug Distributor |
| Licensee Number: | 2004028337 |
| Expiration Date: | 10/31/2017 |
| Original Issue Date: | 9/30/2004 |
| Address: | Frank DiCenso, MIC |
| Address Con't: | 6305 LaSalle Dr |
| City, State Zip: | Lockbourne, OH 43137 |
| County: | Unknown/Out of State |
| Practitioner DBA Name: | AmerisourceBergen Drug Corporation |
| 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
