OLUYEMISI O ADEWUNMI MD
Physician/surgeon


Address: 19 Porter Manor Drive, Waterbury, CT 06705

OLUYEMISI O ADEWUNMI MD (Credential# 557253) is licensed (Physician/surgeon) with Connecticut Department of Consumer Protection. The license effective date is March 28, 2002. The license expiration date date is April 30, 2003. The license status is INACTIVE.

Business Overview

OLUYEMISI O ADEWUNMI MD is licensed with the Department of Consumer Protection of Connecticut. The credential number is #1.039669. The credential type is physician/surgeon. The effective date is March 28, 2002. The expiration date is April 30, 2003. The business address is 19 Porter Manor Drive, Waterbury, CT 06705. The current status is inactive.

Basic Information

Licensee Name OLUYEMISI O ADEWUNMI MD
Credential ID 557253
Credential Number 1.039669
Credential Type Physician/Surgeon
Business Address 19 Porter Manor Drive
Waterbury
CT 06705
Business Type INDIVIDUAL
Status INACTIVE - LAPSED DUE TO NON-RENEWAL
Issue Date 2001-06-29
Effective Date 2002-03-28
Expiration Date 2003-04-30
Refresh Date 2009-07-11

Other licenses

ID Credential Code Credential Type Issue Term Status
265630 CSP.0030639 CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER 2002-03-01 - 2003-02-28 INACTIVE

Office Location

Street Address 19 PORTER MANOR DRIVE
City WATERBURY
State CT
Zip Code 06705

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City WATERBURY
Zip Code 06705
License Type Physician/Surgeon
License Type + County Physician/Surgeon + WATERBURY

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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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