SURAT IZIN PRAKTEK APOTEKER

SARANA PELAYANAN KESEHATAN

IFRS
APOTEK PUSKESMAS GUDANG FARMASI
NO NAMA NOMOR STRA PARIKESIT ABADI SAMBOJA DAYAKU RAJA KOBA
MASA NAMA MASA MASA MASA NAMA MASA
NO. SIPA ALAMAT NO. SIPA NO. SIPA NO. SIPA NO. SIPA NO. SIPA
BERLAKU SARANA BERLAKU BERLAKU BERLAKU SARANA BERLAKU
19911105/
76 M. Zainal Ilmi S.Farm, 19911105/STRA SIPA/64.03/20 05 Nopember
Apt USB/2015/111563 2020
16/1 049

19891115/SIP 15 Nopember 19891115/SIP 15 Nopember

77 M.Lutfi Perdana S.Farm, 19891115/STRA Jl. Pahlawan
UGM/2013/19018 A64.03/2013/ Syifa A/64.03/2017/ 2018
Apt 2018 Tenggarong
1 036 1004

19900321/
78 Media Rahman S.Farm, 19900321/STRA- 19900321/SIP Jl. Pesut RT. 13 No. 3
UGM/2013/19449 A/64.03/2017/ 21 Maret 2018 Aulia SIPA/64.03/20 21 Maret 2018
Apt Timbau Tenggarong 16/1013
1 003

19880607/STRA- 19880607/
Mega Yushita S.Farm,
79 Apt UNHAS/2015/2404 SIPA/64.03/201 Badak Baru 07 Juni 2020
54 6/2 007

80 Merry Handayani,
S.Farm, Apt

19921117/STRA- 19921117/
81 Mirza Amelia S.Farm, Jl. P. Mangkunegara
UNHAS/2015/2428 SIPA/64.03/20 14 Maret 2019 Azmi farma
Apt Tenggarong Seberang
97 16/2 019

19851224/SIP 24 Desember
19851224/STRA Jl. Mulyo Pranoto Loa
82 Nahram S.Farm, Apt A.64.03/2015/ 2018 Keluarga
UII/2013/231349 Kulu
2 080

19831226/
83 Narwin Thamrin.S.Farm, 19831226/STRA- SIPA/64.03/20 26 Desember Jl. M.Hatta Muara
Rahmatullah
Apt UII/2014/10296 2021 Jawa
16/1 039

19931031/SIPA
Nia Oktaviani S.Farm, 19931031/STRA-
84 Apt /64.03/2017/2 Teluk Dalam 31 Oktober 2022
USB/2017/248270 032

19721103/STRA- 19721103/SIP 03 November

85 Nina Rasmita S .Si, Apt UNTAG/2000/2679 A/64.03/2017/ 2021
2 2013

86 Novita Anggriani,
S.Farm, Apt

19861124/SIP 24 Nopember
87 Novita Batong S.Si, Apt 19860124/STRA Jl. Pesut Ruko B
A/64.03/2017/ 2021 Pelangi
ISTN/2010/21132 Tenggarong
2 002
 SARANA PELAYANAN KESEHATAN
IFRS
APOTEK PUSKESMAS GUDANG FARMASI
NO NAMA NOMOR STRA PARIKESIT ABADI SAMBOJA DAYAKU RAJA KOBA
MASA NAMA MASA MASA MASA NAMA MASA
NO. SIPA ALAMAT NO. SIPA NO. SIPA NO. SIPA NO. SIPA NO. SIPA
BERLAKU SARANA BERLAKU BERLAKU BERLAKU SARANA BERLAKU
19781127/SIP 27 November 19781127/SIPA
88 Novita Muryani S.Si, 19781127/STRA Aping Medika 27 Nopember
USB/2002/224128 A.64.03/2015/ 2017 Jl.Teratai Tenggarong .64.03/2015/20 Loa Ipuh
Apt Farma 2017
2 099 96

19931111/SIP 11 Nopember
89 Nur Kholidah Zia 19921111/STRA- Jl. Provinsi Sungai
A/64.03/2017/ 2021 Anggana
S.Farm, Apt USB/2010/21132 Meriam Anggana
2 016

19920716/
90 Nur Latifah S.Farm, Apt 19920710/STRA- SIPA/64.03/20 10 Juli 2021 Akbar 01 Jl. Patin Tenggarong
UII/2016/244039 16/2 028

19891009/STRA 19891009/SIPA
Nur Maulida MS S.
91 Farm, Apt UNJANI/2014/2361 .64.03/2015/2 09 Okt 2019
78 071

19861111/STRA 19861111/SIPA
92 Nur Subhi Hidayat 11 Nopember
UNPAD/2010/1169 /64.03/2017/1 Loa Janan
S.Farm, Apt 2021
8 001

19910308/SIPA
19910308/STRA-
93 Paradillah S.Farm, Apt /64.03/2017/2 08 Maret 2018
UII/2013/233769
022

19900717/STRA- 19900717/SIP
94 Prio Ridho A.S.Farm, UNMUL/2016/1138 A/64.03/2017/ 11 Pebruari Jl. Smd-Ma.Badak
BOHC
Apt 2020 Km.1,5 Ma.badak
67 1 035

19900329/STRA-
95 Purwalinggar S.Si, Apt UNHAS/2015/1117
83

19840712/STRA
96 Putriani S.Si, Apt UNTAG/2013/2345
64

97 Randy Teja Permana,

S.Farm, Apt

19831108/SIP 8 Nopember
19831108/STRA Rizki Mahakam Jl. Jend Sudirman
98 Rasdiana S.Farm, Apt USB/2013/2234259 A64.03/2013/ 2018 Kota Bangun
2 054

99 Reni Septiana, S.Farm,

Apt

19920206/STRA-
100 Reri Ismadiansari 19920206/ 06 Pebruari
UNPAD/2015/2390
S.Farm, Apt SIPA/64.03/20 2020
51
16/2016
ANG FARMASI IF KLINIK

MASA NAMA
NO. SIPA MASA BERLAKU ALAMAT
BERLAKU SARANA
ANG FARMASI IF KLINIK

MASA NAMA
NO. SIPA MASA BERLAKU ALAMAT
BERLAKU SARANA

19900329/SIPA/64 Klinik PT.PMM Loleng 17 Oktober 2017 Jl.Area Kebun Sawit

.03/2017/1033 PT.PMM

19840712/SIPA/64 Jl. M.Hatta Handil III

12 Juli 2018 Klinik Handil
.03/2017/2011 Muara Jawa