FALEN C MATA - Pharmacist License in Wisconsin | # 049238564

FALEN C MATA

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049238564

License Status

NOT RENEWED

Business

N

First Name

FALEN

Middle

C

Last Name

MATA

Prefix

MR

Business Name

FALEN C MATA

Original Issue Date

12/30/2015

Effective Date

12/30/2015

Expiration Date

03/31/2016

State

WI

Ever Disciplined

N

LastModifiedDate

05/20/2016