FALEN C MATA Pharmacist License verification

Business Entity

NOT RENEWED

License Type

Pharmacist

Description

PHARMACY TECHNICIAN

License Number

049238564

License Status

NOT RENEWED

Business

First Name

FALEN

Middle

Last Name

MATA

Prefix

Business Name

FALEN C MATA

Original Issue Date

12/30/2015

Effective Date

12/30/2015

Expiration Date

03/31/2016

City

TREVOR

State

Zip

53179

County

WISCONSIN

Ever Disciplined

LastModifiedDate

05/20/2016