RODRIGO B MATA Medical Doctor License verification

Business Entity

NOT RENEWED

License Type

Medical Doctor

Description

LICENSED PHYSICIAN AND SURGEON

License Number

036085312

License Status

NOT RENEWED

Business

First Name

RODRIGO B

Last Name

MATA

Business Name

RODRIGO B MATA

Original Issue Date

09/11/1992

Effective Date

09/11/1992

Expiration Date

07/31/2002

City

KENOSHA

State

Zip

53142

County

WISCONSIN

Ever Disciplined

LastModifiedDate

10/09/2006