RAFAEL ANTONIO ORTIZ
Physician/surgeon


Address: 616 Blue Hill Road, Riverdale, NJ 07675

RAFAEL ANTONIO ORTIZ (Credential# 555835) is licensed (Physician/surgeon) with Connecticut Department of Consumer Protection. The license effective date is July 1, 2012. The license expiration date date is June 30, 2013. The license status is INACTIVE.

Business Overview

RAFAEL ANTONIO ORTIZ is licensed with the Department of Consumer Protection of Connecticut. The credential number is #1.038245. The credential type is physician/surgeon. The effective date is July 1, 2012. The expiration date is June 30, 2013. The business address is 616 Blue Hill Road, Riverdale, NJ 07675. The current status is inactive.

Basic Information

Licensee Name RAFAEL ANTONIO ORTIZ
Credential ID 555835
Credential Number 1.038245
Credential Type Physician/Surgeon
Business Address 616 Blue Hill Road
Riverdale
NJ 07675
Business Type INDIVIDUAL
Status INACTIVE - LAPSED DUE TO NON-RENEWAL
Issue Date 1999-11-05
Effective Date 2012-07-01
Expiration Date 2013-06-30
Refresh Date 2013-10-08

Office Location

Street Address 616 Blue Hill Road
City Riverdale
State NJ
Zip Code 07675

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City Riverdale
Zip Code 07675
License Type Physician/Surgeon
License Type + County Physician/Surgeon + Riverdale

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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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