Pharmacist

LICENSED CONTROLLED PHARMACY SUBSTANCE

32*****56

NOT RENEWED

Y

CORAM HEALTHCARE CORP OF INDIANA

CORAM CVS SPECIALTY INFUSION SERVICES

09/17/1996

01/22/2018

09/30/2020

CROWN POINT

IN

46307

INDIANA

Hospital/Clinic

II III IV V

N

01/14/2021