SAMUEL ANTHONY MATA - Pharmacist License in Illinois | # 049306620

SAMUEL ANTHONY MATA

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049306620

License Status

NOT RENEWED

Business

N

First Name

SAMUEL

Middle

ANTHONY

Last Name

MATA

Business Name

SAMUEL ANTHONY MATA

Original Issue Date

10/12/2023

Effective Date

03/02/2024

Expiration Date

03/31/2025

State

IL

Ever Disciplined

N

LastModifiedDate

07/08/2025