MICHAEL J WILDERMAN
Physician/surgeon


Address: 666 Greenwich St Apt 410, New York, NY 10014-6331

MICHAEL J WILDERMAN (Credential# 911697) is licensed (Physician/surgeon) with Connecticut Department of Consumer Protection. The license effective date is August 13, 2010. The license expiration date date is December 31, 2010. The license status is INACTIVE.

Business Overview

MICHAEL J WILDERMAN is licensed with the Department of Consumer Protection of Connecticut. The credential number is #1.049108. The credential type is physician/surgeon. The effective date is August 13, 2010. The expiration date is December 31, 2010. The business address is 666 Greenwich St Apt 410, New York, NY 10014-6331. The current status is inactive.

Basic Information

Licensee Name MICHAEL J WILDERMAN
Credential ID 911697
Credential Number 1.049108
Credential Type Physician/Surgeon
Business Address 666 Greenwich St Apt 410
New York
NY 10014-6331
Business Type INDIVIDUAL
Status INACTIVE - LAPSED DUE TO NON-RENEWAL
Issue Date 2010-08-13
Effective Date 2010-08-13
Expiration Date 2010-12-31
Refresh Date 2011-04-04

Office Location

Street Address 666 GREENWICH ST APT 410
City NEW YORK
State NY
Zip Code 10014-6331

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City NEW YORK
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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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