BENJAMIN PODURGIEL JR
Dentist


Address: 30 Atlantic Ave, Groton, CT 06340-8801

BENJAMIN PODURGIEL JR (Credential# 699916) is licensed (Dentist) with Connecticut Department of Consumer Protection. The license effective date is March 1, 2012. The license expiration date date is February 28, 2013. The license status is INACTIVE.

Business Overview

BENJAMIN PODURGIEL JR is licensed with the Department of Consumer Protection of Connecticut. The credential number is #2.003514. The credential type is dentist. The effective date is March 1, 2012. The expiration date is February 28, 2013. The business address is 30 Atlantic Ave, Groton, CT 06340-8801. The current status is inactive.

Basic Information

Licensee Name BENJAMIN PODURGIEL JR
Credential ID 699916
Credential Number 2.003514
Credential Type Dentist
Business Address 30 Atlantic Ave
Groton
CT 06340-8801
Business Type INDIVIDUAL
Status INACTIVE - LAPSED DUE TO NON-RENEWAL
Issue Date 1961-07-06
Effective Date 2012-03-01
Expiration Date 2013-02-28
Refresh Date 2015-03-13

Other licenses

ID Credential Code Credential Type Issue Term Status
143383 CSP.0006807 CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER 2011-03-01 - 2013-02-28 INACTIVE

Office Location

Street Address 30 ATLANTIC AVE
City GROTON
State CT
Zip Code 06340-8801

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Competitor

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City GROTON
Zip Code 06340
License Type Dentist
License Type + County Dentist + GROTON

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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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