JUAN CARLOS DEZA
Physician/surgeon


Address: 26 Bradford Rd, Scarsdale, NY 10583-7652

JUAN CARLOS DEZA (Credential# 1394762) is licensed (Physician/surgeon) with Connecticut Department of Consumer Protection. The license effective date is June 4, 1985. The license expiration date date is November 30, 1988. The license status is INACTIVE.

Business Overview

JUAN CARLOS DEZA is licensed with the Department of Consumer Protection of Connecticut. The credential number is #1.026367. The credential type is physician/surgeon. The effective date is June 4, 1985. The expiration date is November 30, 1988. The business address is 26 Bradford Rd, Scarsdale, NY 10583-7652. The current status is inactive.

Basic Information

Licensee Name JUAN CARLOS DEZA
Credential ID 1394762
Credential Number 1.026367
Credential Type Physician/Surgeon
Business Address 26 Bradford Rd
Scarsdale
NY 10583-7652
Business Type INDIVIDUAL
Status INACTIVE - LAPSED DUE TO NON-RENEWAL
Issue Date 1985-06-04
Effective Date 1985-06-04
Expiration Date 1988-11-30
Refresh Date 2016-12-21

Office Location

Street Address 26 BRADFORD RD
City SCARSDALE
State NY
Zip Code 10583-7652

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City SCARSDALE
Zip Code 10583
License Type Physician/Surgeon
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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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