BYRON OSWALDO MATA Medical Doctor License verification

Business Entity

CANCELLED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****88

License Status

CANCELLED

Business

First Name

BYRON

Middle

OSWALDO

Last Name

MATA

Business Name

BYRON OSWALDO MATA

Original Issue Date

01/12/2007

Effective Date

01/12/2007

Expiration Date

07/31/2008

City

HINES

State

Zip

60141

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/17/2008