JEAN R BURG
Physician/surgeon


Address: 2727 Palisade Ave, Bronx, NY 10463

JEAN R BURG (Credential# 563306) is licensed (Physician/surgeon) with Connecticut Department of Consumer Protection. The license effective date is August 1, 2007. The license expiration date date is August 31, 2008. The license status is INACTIVE.

Business Overview

JEAN R BURG is licensed with the Department of Consumer Protection of Connecticut. The credential number is #1.045724. The credential type is physician/surgeon. The effective date is August 1, 2007. The expiration date is August 31, 2008. The business address is 2727 Palisade Ave, Bronx, NY 10463. The current status is inactive.

Basic Information

Licensee Name JEAN R BURG
Credential ID 563306
Credential Number 1.045724
Credential Type Physician/Surgeon
Business Address 2727 Palisade Ave
Bronx
NY 10463
Business Type INDIVIDUAL
Status INACTIVE - LAPSED DUE TO NON-RENEWAL
Issue Date 2007-08-01
Effective Date 2007-08-01
Expiration Date 2008-08-31
Refresh Date 2009-07-08

Office Location

Street Address 2727 Palisade Ave
City Bronx
State NY
Zip Code 10463

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Yvelisse Aybar 3850 Sedgwick Avenue, Bronx, NY 10463 Master's Level Social Worker 2020-06-01 ~ 2021-05-31
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Jamie Lee Diaz Monsale 3611 Henry Hudson Parkway, Apt 5e, Bronx, NY 10463 Registered Nurse 2020-06-01 ~ 2021-05-31
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City Bronx
Zip Code 10463
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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