RODRIGO B MATA Medical Doctor License verification

Business Entity

EXPIRED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125025901

License Status

EXPIRED

Business

First Name

RODRIGO B

Last Name

MATA

Business Name

RODRIGO B MATA

Original Issue Date

07/13/1990

Effective Date

07/13/1990

Expiration Date

06/30/1993

City

NORTH CHICAGO

State

Zip

60064

County

LAKE

Specialty/Qualifier

Internal Medicine

Ever Disciplined

LastModifiedDate

09/22/2006