JASON JOSEPH
Physician/surgeon


Address: 204 Old Farm Dr, Newington, CT 06111-1851

JASON JOSEPH (Credential# 949295) is licensed (Physician/surgeon) with Connecticut Department of Consumer Protection. The license effective date is April 1, 2012. The license expiration date date is March 31, 2013. The license status is INACTIVE.

Business Overview

JASON JOSEPH is licensed with the Department of Consumer Protection of Connecticut. The credential number is #1.049220. The credential type is physician/surgeon. The effective date is April 1, 2012. The expiration date is March 31, 2013. The business address is 204 Old Farm Dr, Newington, CT 06111-1851. The current status is inactive.

Basic Information

Licensee Name JASON JOSEPH
Credential ID 949295
Credential Number 1.049220
Credential Type Physician/Surgeon
Business Address 204 Old Farm Dr
Newington
CT 06111-1851
Business Type INDIVIDUAL
Status INACTIVE - LAPSED DUE TO NON-RENEWAL
Issue Date 2010-09-20
Effective Date 2012-04-01
Expiration Date 2013-03-31
Refresh Date 2013-07-03

Office Location

Street Address 204 OLD FARM DR
City NEWINGTON
State CT
Zip Code 06111-1851

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City NEWINGTON
Zip Code 06111
License Type Physician/Surgeon
License Type + County Physician/Surgeon + NEWINGTON

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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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