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[7] Payment Request for Recertification (Queued)
Workflow Step

2212022
NBMTM ID

Dr.
Title

Julien
First name

K.
Middle name

Nguyen
Last name

Sr
Suffix

Male
Gender

01/01/1955
Date of birth

contact@nbmtm.org
Email

1
Phone area code

352-521-8456
Phone number

101 Main St
Street Address (line 1)

Suite 4
Street Address (line 2)

Washington
City

DC
State

52125
Zip Code

US
Country

University of Florida
Pharmacy school

PharmD
Type of degree

2012
Year awarded

MBA
Post graduate degree

MTM Experience
Eligibility Type

Training Course
Eligibility Type

MTM Degree
Eligibility Type

Residency
Eligibility Type

US
License Country

DC
License State

AT52615
License Number

US
License Country

DC
License State

AT52615
License Number

US
License Country

DC
License State

AT52615
License Number

US
License Country

DC
License State

AT52615
License Number

Yes
American with Disabilities Act

Private Room
ADA #1 (Special Accommodations)

Private Room
ADA #2 (Special Accommodations)

Reader
ADA #3 (Special Accommodations)

ADA #4 (Special Accommodations)

Paid
Practice Exam

$410
Application Fee

01/02/2020
Eligibility Start

12/31/2020
Eligibility End

03/02/2020
Certfied Start

03/02/2025
Certified End

2,352
Final Score

1325
Certificate ID

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