NICOLE M COSTA Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049155209

License Status

NOT RENEWED

Business

First Name

NICOLE

Middle

Last Name

COSTA

Business Name

NICOLE M COSTA

Original Issue Date

06/16/2004

Effective Date

01/10/2008

Expiration Date

03/31/2009

City

FRANKFORT

State

Zip

60423

County

WILL

Ever Disciplined

LastModifiedDate

05/06/2009