TRAVIS L BOAZ MD (Credential# 558308) is licensed (Physician/surgeon) with Connecticut Department of Consumer Protection. The license effective date is August 1, 2020. The license expiration date date is July 31, 2021. The license status is ACTIVE.
TRAVIS L BOAZ MD is licensed with the Department of Consumer Protection of Connecticut. The credential number is #1.040725. The credential type is physician/surgeon. The effective date is August 1, 2020. The expiration date is July 31, 2021. The business address is 530 E Mcdowell Rd Ste 107-123, Phoenix, AZ 85004-1549. The current status is active.
Licensee Name | TRAVIS L BOAZ MD |
Credential ID | 558308 |
Credential Number | 1.040725 |
Credential Type | Physician/Surgeon |
Business Address |
530 E Mcdowell Rd Ste 107-123 Phoenix AZ 85004-1549 |
Business Type | INDIVIDUAL |
Status | ACTIVE - CURRENT |
Active | 1 |
Issue Date | 2002-08-01 |
Effective Date | 2020-08-01 |
Expiration Date | 2021-07-31 |
Refresh Date | 2020-05-18 |
ID | Credential Code | Credential Type | Issue | Term | Status |
---|---|---|---|---|---|
535644 | CSP.0045667 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 2009-06-22 | 2019-03-01 - 2021-02-28 | ACTIVE |
Street Address | 530 E MCDOWELL RD STE 107-123 |
City | PHOENIX |
State | AZ |
Zip Code | 85004-1549 |
Licensee Name | Office Address | Credential | Effective / Expiration |
---|---|---|---|
Richard M Hasson | 530 E Mcdowell Rd Ste 107-123, Phoenix, AZ 85004-1549 | Physician/surgeon | 2020-03-01 ~ 2021-02-28 |
Licensee Name | Office Address | Credential | Effective / Expiration |
---|---|---|---|
Ryan W Lange | 1 N. Central Ave., Phoenix, AZ 85004 | Home Improvement Contractor | 2019-07-23 ~ 2019-11-30 |
Candice Rae Leden | 600 N 4th St, Phoenix, AZ 85004 | Licensed Practical Nurse | 2011-12-01 ~ 2012-11-30 |
Robert J Penny | 445 N. 5th Street, Phoenix, AZ 85004 | Physician/surgeon | 2010-03-01 ~ 2011-02-28 |
Mountain States Atlantic | 2001 N. 3rd Street, Phoenix, AZ 85004 | Asbestos Contractor | 1995-07-21 ~ 1996-07-31 |
John P Riley | 385 East Coronado Rd, Phoenix, AZ 85004 | Registered Nurse | 1999-02-08 ~ 2000-01-31 |
Dan A Panessa | 2323 N Central Ave Phb, Phoenix, AZ 85004 | Plumbing & Piping Limited Contractor | 1998-11-01 ~ 1999-10-31 |
Ronald Mcdonald House Charities of Central and Northern Arizona Inc | 501 E Roanoke Ave, Phoenix, AZ 85004-1013 | Public Charity | 2019-12-01 ~ 2020-11-30 |
Michael L Haake | 2333 N Central Ave, Phoenix, AZ 85004-1352 | Architect | 2014-09-30 ~ 2015-07-31 |
Perini Building Co Inc · Gco.00616 | 360 E Coronado Rd, Phoenix, AZ 85004-1524 | Major Contractor | 2009-07-01 ~ 2010-06-30 |
Sheila Marie Taylor | 119 E Palm Ln, Phoenix, AZ 85004-1530 | Master's Level Social Worker | 2020-03-30 ~ 2020-11-30 |
Find all Licenses in zip 85004 |
City | PHOENIX |
Zip Code | 85004 |
License Type | Physician/Surgeon |
License Type + County | Physician/Surgeon + PHOENIX |
Licensee Name | Office Address | Credential | Effective / Expiration |
---|---|---|---|
Boaz A Markewitz | 1456 Emerson Ave, Salt Lake City, UT 84105 | Physician/surgeon | 1992-04-24 ~ 1993-01-31 |
Jo M Travis | P.o. Box 66, Heath, MA 01346 | Physician/surgeon | 2012-03-01 ~ 2013-02-28 |
Bradley A Mcgregor | 101 Bodin Circle, Travis Afb, CA 94535 | Physician/surgeon | ~ |
Travis M Smith | 340 S Main St, West Hartford, CT 06107-3618 | Physician/surgeon | 2019-06-01 ~ 2020-05-31 |
William D Travis | 12 Stonygate Oval, New Rochelle, NY 10804 | Physician/surgeon | 2015-10-01 ~ 2016-09-30 |
Ashraf H Mansour | 64 Travis Ave, Staten Island, NY 10314 | Physician/surgeon | 2003-11-25 ~ 2004-04-30 |
John Travis Hinson | 15 New Street, West Hartford, CT 06197 | Physician/surgeon | 2020-04-01 ~ 2021-03-31 |
Craig R Travis | 5901 Sw 87th St, South Miami, FL 33143 | Physician/surgeon | 1997-01-09 ~ 1997-10-31 |
Travis R Von Tobel | 4100 Southpoint Dr E Bldg 1, Jacksonville, FL 32216 | Physician/surgeon | 2020-04-01 ~ 2021-03-31 |
Travis G Snyder Md | 1184 Chapel St Unit 4, New Haven, CT 06511 | Physician/surgeon | 2006-03-27 ~ 2007-03-31 |
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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).