Fagala, Mark David - (Pharmacy Technician)
Kansas City, MO 64154
License# : 2012032693 - Issued on : 9/17/2012
Doing Business As :
| Licensee Name: | Fagala, Mark David |
| Profession Name: | Pharmacy Technician |
| Licensee Number: | 2012032693 |
| Expiration Date: | 5/31/2016 |
| Original Issue Date: | 9/17/2012 |
| Address: | |
| Address Con't: | |
| City, State Zip: | Kansas City, MO 64154 |
| County: | Platte |
| Practitioner DBA Name: | |
| Classification: |
| 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
