FATEMA KANCHWALA
Physical Therapist


Address: 66 Grant St, Waltham, MA 02451-4400

FATEMA KANCHWALA (Credential# 1259991) is licensed (Physical Therapist) with Connecticut Department of Consumer Protection. The license effective date is February 17, 2015. The license expiration date date is February 29, 2016. The license status is INACTIVE.

Business Overview

FATEMA KANCHWALA is licensed with the Department of Consumer Protection of Connecticut. The credential number is #14.010406. The credential type is physical therapist. The effective date is February 17, 2015. The expiration date is February 29, 2016. The business address is 66 Grant St, Waltham, MA 02451-4400. The current status is inactive.

Basic Information

Licensee Name FATEMA KANCHWALA
Credential ID 1259991
Credential Number 14.010406
Credential Type Physical Therapist
Business Address 66 Grant St
Waltham
MA 02451-4400
Business Type INDIVIDUAL
Status INACTIVE - LAPSED DUE TO NON-RENEWAL
Issue Date 2015-02-17
Effective Date 2015-02-17
Expiration Date 2016-02-29
Refresh Date 2016-06-03

Office Location

Street Address 66 GRANT ST
City WALTHAM
State MA
Zip Code 02451-4400

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City WALTHAM
Zip Code 02451
License Type Physical Therapist
License Type + County Physical Therapist + WALTHAM

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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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