DIANA LEBRON
Physician/surgeon


Address: 4104 Maid Stone Dr, Lake Charles, LA 070605

DIANA LEBRON (Credential# 555412) is licensed (Physician/surgeon) with Connecticut Department of Consumer Protection. The license effective date is January 10, 2003. The license expiration date date is December 31, 2003. The license status is INACTIVE.

Business Overview

DIANA LEBRON is licensed with the Department of Consumer Protection of Connecticut. The credential number is #1.037822. The credential type is physician/surgeon. The effective date is January 10, 2003. The expiration date is December 31, 2003. The business address is 4104 Maid Stone Dr, Lake Charles, LA 070605. The current status is inactive.

Basic Information

Licensee Name DIANA LEBRON
Credential ID 555412
Credential Number 1.037822
Credential Type Physician/Surgeon
Business Address 4104 Maid Stone Dr
Lake Charles
LA 070605
Business Type INDIVIDUAL
Status INACTIVE - LAPSED DUE TO NON-RENEWAL
Issue Date 1999-06-04
Effective Date 2003-01-10
Expiration Date 2003-12-31
Refresh Date 2009-07-11

Other licenses

ID Credential Code Credential Type Issue Term Status
218616 CSP.0028492 CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER 2002-05-02 - 2003-02-28 INACTIVE

Office Location

Street Address 4104 MAID STONE DR
City LAKE CHARLES
State LA
Zip Code 070605

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Competitor

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City LAKE CHARLES
Zip Code 07060
License Type Physician/Surgeon
License Type + County Physician/Surgeon + LAKE CHARLES

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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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