AGNES L DALIVA
Physician/surgeon


Address: 111 West High Street, Suite 207, Elkton, MD 21921

AGNES L DALIVA (Credential# 555703) is licensed (Physician/surgeon) with Connecticut Department of Consumer Protection. The license effective date is October 2, 2000. The license expiration date date is September 30, 2001. The license status is INACTIVE.

Business Overview

AGNES L DALIVA is licensed with the Department of Consumer Protection of Connecticut. The credential number is #1.038113. The credential type is physician/surgeon. The effective date is October 2, 2000. The expiration date is September 30, 2001. The business address is 111 West High Street, Suite 207, Elkton, MD 21921. The current status is inactive.

Basic Information

Licensee Name AGNES L DALIVA
Credential ID 555703
Credential Number 1.038113
Credential Type Physician/Surgeon
Business Address 111 West High Street, Suite 207
Elkton
MD 21921
Business Type INDIVIDUAL
Status INACTIVE - LAPSED DUE TO NON-RENEWAL
Issue Date 1999-09-08
Effective Date 2000-10-02
Expiration Date 2001-09-30
Refresh Date 2009-07-08

Office Location

Street Address 111 West High Street, Suite 207
City Elkton
State MD
Zip Code 21921

Licenses in the same zip code

Licensee Name Office Address Credential Effective / Expiration
Lillian Alt 106 Bow St, Elkton, MD 21921 Physician/surgeon ~
Jerri Barnett 27 Cherry Lane, Elkton, MD 21921 Registered Nurse 2016-12-01 ~ 2017-11-30
Lauren Kingsley Foreman 281 Molitor Rd, Elkton, MD 21921 Registered Nurse - Temporary 2017-03-13 ~ 2017-07-10
Anna C Hammond 6 John Adams Lane, Elkton, MD 21921 Licensed Practical Nurse 2009-05-01 ~ 2010-04-30
Kevin W Flanagan 118 Bowling Lane, Elkton, MD 21921 Asbestos Abatement Worker 2002-02-11 ~ 2002-10-31
Thomas L Velotti 137 Big Elk Mall, Elkton, MD 21921 Podiatrist 1994-09-12 ~ 1995-09-30
Karen M Szczepanik 2734 Barksdale Road, Elkton, MD 21921 Registered Nurse 1996-02-16 ~ 1997-02-28
John A Exum Jr. 300a4 Westcreek Village, Elkton, MD 21921 Asbestos Abatement Worker 2002-04-26 ~ 2002-07-31
Louis Davila 105 Deerfield Road, Apt. B, Elkton, MD 21921 Asbestos Abatement Supervisor 2003-02-19 ~ 2004-02-29
Jennifer C Minton 3 Hullihen Dr, Elkton, MD 21921-2002 Registered Nurse 2019-11-01 ~ 2020-10-31
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Competitor

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City Elkton
Zip Code 21921
License Type Physician/Surgeon
License Type + County Physician/Surgeon + Elkton

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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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