LEA A BONIFACIO
Physician/surgeon


Address: 416 Bluebird Drive, Russell, KY 41169

LEA A BONIFACIO (Credential# 557733) is licensed (Physician/surgeon) with Connecticut Department of Consumer Protection. The license effective date is December 6, 2005. The license expiration date date is January 31, 2007. The license status is INACTIVE.

Business Overview

LEA A BONIFACIO is licensed with the Department of Consumer Protection of Connecticut. The credential number is #1.040150. The credential type is physician/surgeon. The effective date is December 6, 2005. The expiration date is January 31, 2007. The business address is 416 Bluebird Drive, Russell, KY 41169. The current status is inactive.

Basic Information

Licensee Name LEA A BONIFACIO
Credential ID 557733
Credential Number 1.040150
Credential Type Physician/Surgeon
Business Address 416 Bluebird Drive
Russell
KY 41169
Business Type INDIVIDUAL
Status INACTIVE - LAPSED DUE TO NON-RENEWAL
Issue Date 2002-02-13
Effective Date 2005-12-06
Expiration Date 2007-01-31
Refresh Date 2009-07-08

Office Location

Street Address 416 Bluebird Drive
City Russell
State KY
Zip Code 41169

Licenses in the same zip code

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Saadi Alhalbouni 216 Amanda St Apt B, Russell, KY 41169-1313 Controlled Substance Registration for Practitioner ~

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Brianna Marie Weltlich 35 Woodland Way, Russell, MA 01071-9652 Occupational Therapist 2020-03-04 ~ 2021-07-31
Raymond J Anton Md Raymond J. Anton, M.d., Russell, MA 01071 Physician/surgeon 2020-04-01 ~ 2021-03-31
Brad D Emmonds 76 Patriots Path, Russell, MA 01071-9763 Electrical Unlimited Journeyperson 2020-01-14 ~ 2020-09-30
Nicholas Haftmann · H & S Construction 620 S Quarter Rd, Russell, MA 01071 Home Improvement Contractor 2018-12-01 ~ 2019-11-30
Eleanor A Blanchard 965 Blandford Road, Russell, MA 01071 Notary Public Appointment 2013-05-16 ~ 2018-05-31
Carrie Ann Tweed 1157 Huntington Rd, Russell, MA 01071-9527 Dental Hygienist 2018-08-31 ~ 2019-07-31
Guy S Jediny 285 General Knox Rd, Russell, MA 01071-9610 Plumbing & Piping Limited Journeyperson 2019-11-01 ~ 2020-10-31
James E Cote 53 Timberidge Dr, Russell, MA 01071-9747 Plumbing & Piping Unlimited Contractor 2019-11-01 ~ 2020-10-31
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Competitor

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City Russell
Zip Code 41169
License Type Physician/Surgeon
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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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