RAYMOND A DIAZ MD
Physician/surgeon


Address: 121 Montoya Dr, Branford, CT 06405

RAYMOND A DIAZ MD (Credential# 552378) is licensed (Physician/surgeon) with Connecticut Department of Consumer Protection. The license effective date is February 11, 1999. The license expiration date date is March 31, 2000. The license status is INACTIVE.

Business Overview

RAYMOND A DIAZ MD is licensed with the Department of Consumer Protection of Connecticut. The credential number is #1.034782. The credential type is physician/surgeon. The effective date is February 11, 1999. The expiration date is March 31, 2000. The business address is 121 Montoya Dr, Branford, CT 06405. The current status is inactive.

Basic Information

Licensee Name RAYMOND A DIAZ MD
Credential ID 552378
Credential Number 1.034782
Credential Type Physician/Surgeon
Business Address 121 Montoya Dr
Branford
CT 06405
Business Type INDIVIDUAL
Status INACTIVE - LAPSED DUE TO NON-RENEWAL
Issue Date 1995-08-11
Effective Date 1999-02-11
Expiration Date 2000-03-31
Refresh Date 2009-07-11

Other licenses

ID Credential Code Credential Type Issue Term Status
170836 CSP.0024116 CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER 1999-03-01 - 2000-02-28 INACTIVE

Office Location

Street Address 121 MONTOYA DR
City BRANFORD
State CT
Zip Code 06405

Licenses in the same location

Licensee Name Office Address Credential Effective / Expiration
Richard R Roughton 121 Montoya Dr, Branford, CT 06405-2502 Milk Examiner 2015-03-23 ~ 2017-03-22

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Bridget J Jennings 159 Queach Road, Branford, CT 06405 Registered Nurse 2020-09-01 ~ 2021-08-31
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Cathleen Smith 50 First Avenue, Branford, CT 06405 Radiographer 2020-07-01 ~ 2021-06-30
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Competitor

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City BRANFORD
Zip Code 06405
License Type Physician/Surgeon
License Type + County Physician/Surgeon + BRANFORD

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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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