AmerisourceBergen Drug Corporation - (Drug Distributor)
John C Stavich, MIC
Corona, MO 92881
License# : 2004007384 - Issued on : 3/17/2004
Doing Business As : AmerisourceBergen Drug Company
| Licensee Name: | AmerisourceBergen Drug Corporation |
| Profession Name: | Drug Distributor |
| Licensee Number: | 2004007384 |
| Expiration Date: | 10/31/2015 |
| Original Issue Date: | 3/17/2004 |
| Address: | John C Stavich, MIC |
| Address Con't: | 1851 California Avenue |
| City, State Zip: | Corona, CA 92881 |
| County: | Unknown/Out of State |
| Practitioner DBA Name: | AmerisourceBergen Drug Company |
| 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
