NICOLE MARIE GENTILE MD Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049147111

License Status

NOT RENEWED

Business

Title

First Name

NICOLE

Middle

MARIE

Last Name

GENTILE

Business Name

NICOLE MARIE GENTILE MD

Original Issue Date

02/19/2003

Effective Date

02/19/2003

Expiration Date

03/31/2005

City

LAKE BARRINGTON

State

Zip

60010

Ever Disciplined

LastModifiedDate

10/20/2005