IRA B FULTONBERG
Physical Therapist


Address: 1009 Monarch Way, Superior, CO 80027

IRA B FULTONBERG (Credential# 690225) is licensed (Physical Therapist) with Connecticut Department of Consumer Protection. The license effective date is June 10, 2003. The license expiration date date is July 31, 2004. The license status is INACTIVE.

Business Overview

IRA B FULTONBERG is licensed with the Department of Consumer Protection of Connecticut. The credential number is #14.004644. The credential type is physical therapist. The effective date is June 10, 2003. The expiration date is July 31, 2004. The business address is 1009 Monarch Way, Superior, CO 80027. The current status is inactive.

Basic Information

Licensee Name IRA B FULTONBERG
Credential ID 690225
Credential Number 14.004644
Credential Type Physical Therapist
Business Address 1009 Monarch Way
Superior
CO 80027
Business Type INDIVIDUAL
Status INACTIVE - LAPSED DUE TO NON-RENEWAL
Issue Date 1992-12-10
Effective Date 2003-06-10
Expiration Date 2004-07-31
Refresh Date 2009-07-08

Office Location

Street Address 1009 MONARCH WAY
City SUPERIOR
State CO
Zip Code 80027

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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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