NICOLE ANN MELLICAN Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049163238

License Status

NOT RENEWED

Business

First Name

NICOLE

Middle

ANN

Last Name

MELLICAN

Business Name

NICOLE ANN MELLICAN

Original Issue Date

08/25/2005

Effective Date

03/22/2011

Expiration Date

03/31/2012

City

WASHINGTON

State

Zip

61571

County

TAZEWELL

Ever Disciplined

LastModifiedDate

05/07/2012