ANDRES MASCARO PANKOVA
Resident Physician


Address: 308south24th Street, Philadelphia, PA 19103

ANDRES MASCARO PANKOVA (Credential# 1490837) is licensed (Resident Physician) with Connecticut Department of Consumer Protection. The license effective date is July 7, 2014. The license expiration date date is June 30, 2020. The license status is ACTIVE.

Business Overview

ANDRES MASCARO PANKOVA is licensed with the Department of Consumer Protection of Connecticut. The credential number is #1.058939-RES. The credential type is resident physician. The effective date is July 7, 2014. The expiration date is June 30, 2020. The business address is 308south24th Street, Philadelphia, PA 19103. The current status is active.

Basic Information

Licensee Name ANDRES MASCARO PANKOVA
Credential ID 1490837
Credential Number 1.058939-RES
Credential Type Resident Physician
Credential SubCategory RES
Business Address 308south24th Street
Philadelphia
PA 19103
Business Type INDIVIDUAL
Status ACTIVE - CURRENT
Active 1
Issue Date 2014-07-07
Effective Date 2014-07-07
Expiration Date 2020-06-30
Refresh Date 2019-05-16

Other licenses

ID Credential Code Credential Type Issue Term Status
1216702 CSP.0056988 CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER - INACTIVE

Office Location

Street Address 308south24th street
City Philadelphia
State PA
Zip Code 19103

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Competitor

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City Philadelphia
Zip Code 19103
License Type Resident Physician
License Type + County Resident Physician + 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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