AmerisourceBergen Drug Corporation - (Drug Distributor)
Matthew Stine, MIC
Kansas City, MO 64153
License# : 2005017289 - Issued on : 6/8/2005
Doing Business As : AmerisourceBergen Drug Corporation
| Licensee Name: | AmerisourceBergen Drug Corporation |
| Profession Name: | Drug Distributor |
| Licensee Number: | 2005017289 |
| Expiration Date: | 10/31/2017 |
| Original Issue Date: | 6/8/2005 |
| Address: | Matthew Stine, MIC |
| Address Con't: | 11200 North Congress |
| City, State Zip: | Kansas City, MO 64153 |
| County: | Platte |
| Practitioner DBA Name: | AmerisourceBergen Drug Corporation |
| Classification: | Wholesale Drug Distributor |
| 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
