JEFFREY K BIGELOW
Physician/surgeon


Address: 111 Park St, # 12-5, New Haven, CT 06571

JEFFREY K BIGELOW (Credential# 564501) is licensed (Physician/surgeon) with Connecticut Department of Consumer Protection. The license effective date is July 3, 2009. The license expiration date date is July 31, 2010. The license status is INACTIVE.

Business Overview

JEFFREY K BIGELOW is licensed with the Department of Consumer Protection of Connecticut. The credential number is #1.046919. The credential type is physician/surgeon. The effective date is July 3, 2009. The expiration date is July 31, 2010. The business address is 111 Park St, # 12-5, New Haven, CT 06571. The current status is inactive.

Basic Information

Licensee Name JEFFREY K BIGELOW
Credential ID 564501
Credential Number 1.046919
Credential Type Physician/Surgeon
Business Address 111 Park St, # 12-5
New Haven
CT 06571
Business Type INDIVIDUAL
Status INACTIVE - LAPSED DUE TO NON-RENEWAL
Issue Date 2008-08-19
Effective Date 2009-07-03
Expiration Date 2010-07-31
Refresh Date 2010-11-02

Other licenses

ID Credential Code Credential Type Issue Term Status
441400 CSP.0039339 CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER 2006-06-19 2007-03-01 - 2008-02-29 INACTIVE

Office Location

Street Address 111 Park St, # 12-5
City New Haven
State CT
Zip Code 06571

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City New Haven
Zip Code 06571
License Type Physician/Surgeon
License Type + County Physician/Surgeon + New Haven

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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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