FOULA KONTONICOLAS
Physician/surgeon


Address: 6 Canterbury Ct, Brookfield, CT 06804-2703

FOULA KONTONICOLAS (Credential# 1282884) is licensed (Physician/surgeon) with Connecticut Department of Consumer Protection. The license effective date is August 1, 2016. The license expiration date date is July 31, 2017. The license status is INACTIVE.

Business Overview

FOULA KONTONICOLAS is licensed with the Department of Consumer Protection of Connecticut. The credential number is #1.054448. The credential type is physician/surgeon. The effective date is August 1, 2016. The expiration date is July 31, 2017. The business address is 6 Canterbury Ct, Brookfield, CT 06804-2703. The current status is inactive.

Basic Information

Licensee Name FOULA KONTONICOLAS
Credential ID 1282884
Credential Number 1.054448
Credential Type Physician/Surgeon
Business Address 6 Canterbury Ct
Brookfield
CT 06804-2703
Business Type INDIVIDUAL
Status INACTIVE - LAPSED DUE TO NON-RENEWAL
Issue Date 2015-07-28
Effective Date 2016-08-01
Expiration Date 2017-07-31
Refresh Date 2017-11-03

Other licenses

ID Credential Code Credential Type Issue Term Status
947985 CSP.0048525 CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER 2010-09-15 2015-03-01 - 2017-02-28 INACTIVE

Office Location

Street Address 6 CANTERBURY CT
City BROOKFIELD
State CT
Zip Code 06804-2703

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City BROOKFIELD
Zip Code 06804
License Type Physician/Surgeon
License Type + County Physician/Surgeon + BROOKFIELD

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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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