CHRISTINE MARIE MATA MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****62

License Status

ACTIVE

Business

Title

First Name

CHRISTINE

Middle

MARIE

Last Name

MATA

Business Name

CHRISTINE MARIE MATA MD

Original Issue Date

10/22/2015

Effective Date

04/07/2023

Expiration Date

07/31/2026

City

NILES

State

Zip

60714

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/07/2023