For those of you running Exchange 2010 SP3, we learned through trial and error that you cannot just install the roll up on a single system for testing. We did this on a server with the CAS role and we were not able to access any mailboxes on this server from OWA so we reverted back to the prior roll up. It would have been helpful if this was included in the documentation for the roll up or perhaps even a pop-up when installing. Someone at Microsoft must know this since there is message in the Event Log that would help you arrive at this conclusion. Thanks to those who provided suggestions at running the couple of PowerShell scripts that some needed to run. In our case all we had to do is patch all the serves at the same time, reboot and test things -- no need to run those PowerShell scripts.
Based on the number of persons who did not read the release notes to know to install the update with an elevated command prompt, it really would be in Microsoft's best interest to put this type of information in a dialog when you run the installers...it should be trivial to add this to EVERY patch Microsoft releases since time is of the essence...it is not like most organizations can down an Exchange server willy nilly. Ideally the code in the patch should check to see if the installer is running in an elevated command prompt, but if that is not possible then a simple dialog with the info with a checkbox to force them to read would have protected many, many more customers sooner.
Now that we are patched we are making forward progress and finally getting rid of this beast on prem.