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MATT BELMONT — OIG Excluded Provider (MORTON, IL, 1128b4)

MATT BELMONT — OIG Excluded Provider (MORTON, IL, 1128b4) is one of 9,000 exclusions in the ExcludeCheck dataset. Key details — Name: MATT BELMONT; Type: Individual; Provider category: PHARMACY.

NameMATT BELMONT
TypeIndividual
Provider categoryPHARMACY
SpecialtyTECHNICIAN
CityMORTON
StateIL
ZIP61550
Exclusion authority1128b4
Exclusion reasonLicense revocation, suspension, or surrender
Exclusion date1998-03-19
SourceHHS-OIG LEIE

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