RICHARD H BRODY
Physician/surgeon


Address: 145 Coventry Lane, Longmeadow, MA 01106

RICHARD H BRODY (Credential# 551391) is licensed (Physician/surgeon) with Connecticut Department of Consumer Protection. The license effective date is January 3, 1997. The license expiration date date is February 28, 1998. The license status is INACTIVE.

Business Overview

RICHARD H BRODY is licensed with the Department of Consumer Protection of Connecticut. The credential number is #1.033792. The credential type is physician/surgeon. The effective date is January 3, 1997. The expiration date is February 28, 1998. The business address is 145 Coventry Lane, Longmeadow, MA 01106. The current status is inactive.

Basic Information

Licensee Name RICHARD H BRODY
Credential ID 551391
Credential Number 1.033792
Credential Type Physician/Surgeon
Business Address 145 Coventry Lane
Longmeadow
MA 01106
Business Type INDIVIDUAL
Status INACTIVE - LAPSED DUE TO NON-RENEWAL
Issue Date 1994-06-10
Effective Date 1997-01-03
Expiration Date 1998-02-28
Refresh Date 2009-07-08

Other licenses

ID Credential Code Credential Type Issue Term Status
161535 CSP.0022511 CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER 1994-09-15 - 1996-07-01 INACTIVE

Office Location

Street Address 145 COVENTRY LANE
City LONGMEADOW
State MA
Zip Code 01106

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City LONGMEADOW
Zip Code 01106
License Type Physician/Surgeon
License Type + County Physician/Surgeon + LONGMEADOW

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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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