DAVID S VAN DYKE Pharmacist License verification

DAVID S VAN DYKE

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

REGISTERED PHARMACIST

License Number

051034259

License Status

NOT RENEWED

Business

First Name

DAVID S

Last Name

VAN DYKE

Business Name

DAVID S VAN DYKE

Original Issue Date

05/11/1982

Effective Date

05/11/1982

Expiration Date

03/31/2004

City

SANTA FE

State

Zip

87505

County

NEW MEXICO

Ever Disciplined

LastModifiedDate

04/29/2011

Case Number

2011000162

Action

Refuse To Renew

Discipline Start Date

04/26/2011

Discipline Reason

as a result of his pharmacist license having been summarily suspended by the New Mexico State Board of Pharmacy on or about October 22, 2010, for failure to undergo an evaluation by the New Mexico Monitored Treatment Program as ordered by the New Mexico State Board of Pharmacy's Impaired Health Care Provider Examining Committee on December 9, 2008.