NIZAR C CHARAFEDDINE
Physician/surgeon


Address: 219 Highland Avenue, Wallingford, CT 06492

NIZAR C CHARAFEDDINE (Credential# 552523) is licensed (Physician/surgeon) with Connecticut Department of Consumer Protection. The license effective date is June 29, 1998. The license expiration date date is June 30, 1999. The license status is INACTIVE.

Business Overview

NIZAR C CHARAFEDDINE is licensed with the Department of Consumer Protection of Connecticut. The credential number is #1.034928. The credential type is physician/surgeon. The effective date is June 29, 1998. The expiration date is June 30, 1999. The business address is 219 Highland Avenue, Wallingford, CT 06492. The current status is inactive.

Basic Information

Licensee Name NIZAR C CHARAFEDDINE
Credential ID 552523
Credential Number 1.034928
Credential Type Physician/Surgeon
Business Address 219 Highland Avenue
Wallingford
CT 06492
Business Type INDIVIDUAL
Status INACTIVE - LAPSED DUE TO NON-RENEWAL
Issue Date 1995-10-27
Effective Date 1998-06-29
Expiration Date 1999-06-30
Refresh Date 2009-07-08

Other licenses

ID Credential Code Credential Type Issue Term Status
163252 CSP.0023868 CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER 1998-03-01 - 1999-02-28 INACTIVE

Office Location

Street Address 219 HIGHLAND AVENUE
City WALLINGFORD
State CT
Zip Code 06492

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Dianna K Ball 104 Simpson Ave, Wallingford, CT 06492 Speech and Language Pathologist 2020-08-01 ~ 2021-07-31
Ann Marie Richardson 20 Mohawk Drive, Wallingford, CT 06492 Registered Nurse 2020-07-01 ~ 2021-06-30
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Competitor

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City WALLINGFORD
Zip Code 06492
License Type Physician/Surgeon
License Type + County Physician/Surgeon + WALLINGFORD

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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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