MELISSA A UMPHLETT
Physician/surgeon


Address: 213 W 71st St Apt 3a, New York, NY 10023-3777

MELISSA A UMPHLETT (Credential# 1053151) is licensed (Physician/surgeon) with Connecticut Department of Consumer Protection. The license effective date is July 1, 2013. The license expiration date date is June 30, 2014. The license status is PENDING.

Business Overview

MELISSA A UMPHLETT is licensed with the Department of Consumer Protection of Connecticut. The credential number is #1.051062. The credential type is physician/surgeon. The effective date is July 1, 2013. The expiration date is June 30, 2014. The business address is 213 W 71st St Apt 3a, New York, NY 10023-3777. The current status is pending.

Basic Information

Licensee Name MELISSA A UMPHLETT
Credential ID 1053151
Credential Number 1.051062
Credential Type Physician/Surgeon
Business Address 213 W 71st St Apt 3a
New York
NY 10023-3777
Business Type INDIVIDUAL
Status PENDING - REINSTATEMENT APPLICATION PENDING
Issue Date 2012-06-18
Effective Date 2013-07-01
Expiration Date 2014-06-30
Refresh Date 2015-03-23

Office Location

Street Address 213 W 71ST ST APT 3A
City NEW YORK
State NY
Zip Code 10023-3777

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City NEW YORK
Zip Code 10023
License Type Physician/Surgeon
License Type + County Physician/Surgeon + NEW YORK

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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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