NORBERTINA L BANSON
Physician/surgeon


Address: 10101 Farrcroft Drive, Fairfax, VA 22030

NORBERTINA L BANSON (Credential# 558791) is licensed (Physician/surgeon) with Connecticut Department of Consumer Protection. The license effective date is July 24, 2006. The license expiration date date is September 30, 2007. The license status is INACTIVE.

Business Overview

NORBERTINA L BANSON is licensed with the Department of Consumer Protection of Connecticut. The credential number is #1.041208. The credential type is physician/surgeon. The effective date is July 24, 2006. The expiration date is September 30, 2007. The business address is 10101 Farrcroft Drive, Fairfax, VA 22030. The current status is inactive.

Basic Information

Licensee Name NORBERTINA L BANSON
Credential ID 558791
Credential Number 1.041208
Credential Type Physician/Surgeon
Business Address 10101 Farrcroft Drive
Fairfax
VA 22030
Business Type INDIVIDUAL
Status INACTIVE - LAPSED DUE TO NON-RENEWAL
Issue Date 2003-03-06
Effective Date 2006-07-24
Expiration Date 2007-09-30
Refresh Date 2009-07-08

Office Location

Street Address 10101 Farrcroft Drive
City Fairfax
State VA
Zip Code 22030

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City Fairfax
Zip Code 22030
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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