ILYA MICHAEL AVERBUCH
Physician/surgeon


Address: Po Box 11535, Philadelphia, PA 19116-0535

ILYA MICHAEL AVERBUCH (Credential# 1031020) is licensed (Physician/surgeon) with Connecticut Department of Consumer Protection. The license effective date is May 24, 1991. The license expiration date date is March 31, 1992. The license status is INACTIVE.

Business Overview

ILYA MICHAEL AVERBUCH is licensed with the Department of Consumer Protection of Connecticut. The credential number is #1.031566. The credential type is physician/surgeon. The effective date is May 24, 1991. The expiration date is March 31, 1992. The business address is Po Box 11535, Philadelphia, PA 19116-0535. The current status is inactive.

Basic Information

Licensee Name ILYA MICHAEL AVERBUCH
Credential ID 1031020
Credential Number 1.031566
Credential Type Physician/Surgeon
Business Address Po Box 11535
Philadelphia
PA 19116-0535
Business Type INDIVIDUAL
Status INACTIVE - LAPSED DUE TO NON-RENEWAL
Issue Date 1991-05-24
Effective Date 1991-05-24
Expiration Date 1992-03-31
Refresh Date 2011-09-16

Office Location

Street Address PO BOX 11535
City PHILADELPHIA
State PA
Zip Code 19116-0535

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City PHILADELPHIA
Zip Code 19116
License Type Physician/Surgeon
License Type + County Physician/Surgeon + PHILADELPHIA

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Dataset Information

Data Provider Connecticut Department of Consumer Protection
Jurisdiction Connecticut
Related Datasets Connecticut Business Registrations, Connecticut Child Care Facilities

This dataset includes 1.41 million licenses issued wtih Connecticut Department of Consumer Protection (TDLR).

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