MICHAEL J STEPHEN
Physician/surgeon


Address: 16 Fresh Pond Lane, Cambridge, MA 02138

MICHAEL J STEPHEN (Credential# 560362) is licensed (Physician/surgeon) with Connecticut Department of Consumer Protection. The license effective date is September 3, 2004. The license expiration date date is July 31, 2005. The license status is INACTIVE.

Business Overview

MICHAEL J STEPHEN is licensed with the Department of Consumer Protection of Connecticut. The credential number is #1.042780. The credential type is physician/surgeon. The effective date is September 3, 2004. The expiration date is July 31, 2005. The business address is 16 Fresh Pond Lane, Cambridge, MA 02138. The current status is inactive.

Basic Information

Licensee Name MICHAEL J STEPHEN
Credential ID 560362
Credential Number 1.042780
Credential Type Physician/Surgeon
Business Address 16 Fresh Pond Lane
Cambridge
MA 02138
Business Type INDIVIDUAL
Status INACTIVE - LAPSED DUE TO NON-RENEWAL
Issue Date 2004-09-03
Effective Date 2004-09-03
Expiration Date 2005-07-31
Refresh Date 2009-07-08

Office Location

Street Address 16 Fresh Pond Lane
City Cambridge
State MA
Zip Code 02138

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City Cambridge
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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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