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Individual

MOLLY E LICKLITER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PHARM.D.

Contact information

Practice address
1330 W 86TH ST, INDIANAPOLIS, IN 46260-2102
(317) 228-0419
(317) 228-0292
Mailing address
1330 W 86TH ST, INDIANAPOLIS, IN 46260-2102
(317) 228-0419
(317) 228-0292

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
20837
IA
183500000X
Pharmacist
26023531A
IN

Other

Enumeration date
10/14/2011
Last updated
10/14/2011
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