MATTHEW TYLER NICKENS - Pharmacist License in Illinois | # 049193129

MATTHEW TYLER NICKENS

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049193129

License Status

NOT RENEWED

Business

N

First Name

MATTHEW

Middle

TYLER

Last Name

NICKENS

Business Name

MATTHEW TYLER NICKENS

Original Issue Date

07/21/2009

Effective Date

03/08/2010

Expiration Date

03/31/2011

State

IL

Ever Disciplined

N

LastModifiedDate

05/12/2011