USAMA M MOUSTAFA
Physician/surgeon


Address: 200 Lake Shore Drive, Michigan City, IN 46360

USAMA M MOUSTAFA (Credential# 563416) is licensed (Physician/surgeon) with Connecticut Department of Consumer Protection. The license effective date is September 5, 2007. The license expiration date date is September 30, 2008. The license status is INACTIVE.

Business Overview

USAMA M MOUSTAFA is licensed with the Department of Consumer Protection of Connecticut. The credential number is #1.045834. The credential type is physician/surgeon. The effective date is September 5, 2007. The expiration date is September 30, 2008. The business address is 200 Lake Shore Drive, Michigan City, IN 46360. The current status is inactive.

Basic Information

Licensee Name USAMA M MOUSTAFA
Credential ID 563416
Credential Number 1.045834
Credential Type Physician/Surgeon
Business Address 200 Lake Shore Drive
Michigan City
IN 46360
Business Type INDIVIDUAL
Status INACTIVE - LAPSED DUE TO NON-RENEWAL
Issue Date 2007-09-05
Effective Date 2007-09-05
Expiration Date 2008-09-30
Refresh Date 2009-07-08

Office Location

Street Address 200 Lake Shore Drive
City Michigan City
State IN
Zip Code 46360

Licenses in the same zip code

Licensee Name Office Address Credential Effective / Expiration
Christopher G Raia 3209 Dody Ave Apt. #6, Michigan City, IN 46360 Engineer-in-training ~
Monica Langdon Lorimer 2920 Roslyn Trl, Long Beach, IN 46360-1726 Controlled Substance Registration for Practitioner 2018-12-28 ~ 2019-02-28
Donald J Siebert · Pj Siebert Inc 15 Muirfield Dr, Michigan City, IN 46360-1823 Closing Out Sale Promoter 2018-11-27 ~ 2019-10-19
Michelle Rene' Lovelace 1112 W 8th St, Michigan City, IN 46360-3924 Registered Nurse - Temporary 2019-04-26 ~ 2019-08-24

Competitor

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City Michigan City
Zip Code 46360
License Type Physician/Surgeon
License Type + County Physician/Surgeon + Michigan City

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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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