KENYATTA NICOLE PATRICK Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049136155

License Status

NOT RENEWED

Business

First Name

KENYATTA

Middle

NICOLE

Last Name

PATRICK

Business Name

KENYATTA NICOLE PATRICK

BusinessDBA

NICOLE PATRICK

Original Issue Date

05/01/2001

Effective Date

05/01/2001

Expiration Date

03/31/2003

City

KATY

State

Zip

77494

Ever Disciplined

LastModifiedDate

10/17/2005

Case Number

2002001599

Action

Suspension

Discipline Start Date

10/08/2003

Discipline Reason

Failed to file and/or pay Illinois income taxes.