CHRISTINE MARIE MATA MD Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

TEMPORARY MEDICAL PERMIT

License Number

125057919

License Status

CANCELLED

Business

Title

First Name

CHRISTINE

Middle

MARIE

Last Name

MATA

Business Name

CHRISTINE MARIE MATA MD

Original Issue Date

07/01/2013

Effective Date

07/01/2013

Expiration Date

06/30/2014

City

HOFFMAN ESTATES

State

Zip

60192

Specialty/Qualifier

Ophthalmology

Ever Disciplined

LastModifiedDate

03/24/2014