WAYNE RALPH BREITWIESER (Credential# 998645) is licensed (Physician/surgeon) with Connecticut Department of Consumer Protection. The license effective date is April 15, 1974. The license expiration date date is October 31, 1981. The license status is INACTIVE.
WAYNE RALPH BREITWIESER is licensed with the Department of Consumer Protection of Connecticut. The credential number is #1.016568. The credential type is physician/surgeon. The effective date is April 15, 1974. The expiration date is October 31, 1981. The business address is 6225 4th St, Bloomsburg, PA 17815-8731. The current status is inactive.
Licensee Name | WAYNE RALPH BREITWIESER |
Credential ID | 998645 |
Credential Number | 1.016568 |
Credential Type | Physician/Surgeon |
Business Address |
6225 4th St Bloomsburg PA 17815-8731 |
Business Type | INDIVIDUAL |
Status | INACTIVE - LAPSED DUE TO NON-RENEWAL |
Issue Date | 1974-04-15 |
Effective Date | 1974-04-15 |
Expiration Date | 1981-10-31 |
Refresh Date | 2013-12-09 |
Street Address | 6225 4TH ST |
City | BLOOMSBURG |
State | PA |
Zip Code | 17815-8731 |
Licensee Name | Office Address | Credential | Effective / Expiration |
---|---|---|---|
Michael H Queen | 1103 Cherry Hill Rd, Bloomsburg, PA 17815 | Professional Engineer | 2020-02-01 ~ 2021-01-31 |
Matthew J Vertucci | 3029 Woods Edge Dr, Bloomsburg, PA 17815 | Professional Engineer | 2020-02-01 ~ 2021-01-31 |
Gino J Mongelluzzo | 213 W 3rd St, Bloomsburg, PA 17815 | Resident Physician | 2015-06-25 ~ 2019-06-30 |
Gerald R Bodman | 98 Church Roadr, Bloomsburg, PA 17815 | Professional Engineer | 2003-02-01 ~ 2004-01-31 |
Tracie A Wood | 117 Hemlock Lane, Bloomsburg, PA 17815 | Physical Therapist | 2008-10-21 ~ 2009-12-31 |
Helen J Lough | P.o. Box 357, Bloomsburg, PA 17815 | Licensed Practical Nurse | 2004-09-13 ~ 2005-09-30 |
Jeffery O Skjoldal Jr. | 76 Kile Drive, Bloomsburg, PA 17815 | Asbestos Abatement Supervisor | 2004-01-26 ~ 2004-04-30 |
Leesa J Masteller | Rd #3 Boc 195, Bloomburg, PA 17815 | Physical Therapist | ~ 1999-02-28 |
Alice F Wilson | 134 East 12th St, Bloomsburg, PA 17815 | Registered Nurse | 1992-06-25 ~ 1993-05-31 |
Joseph Shovlin Md | 1250 Chestnut Street, Bloomburg, PA 17815 | Controlled Substance Registration for Practitioner | 1998-04-02 ~ 1999-02-28 |
Find all Licenses in zip 17815 |
City | BLOOMSBURG |
Zip Code | 17815 |
License Type | Physician/Surgeon |
License Type + County | Physician/Surgeon + BLOOMSBURG |
Licensee Name | Office Address | Credential | Effective / Expiration |
---|---|---|---|
Wayne Gilbertie Md · Radiology & Imaging | Wayne Gilbertie, Md, Glastonbury, CT 06033 | Physician/surgeon | 2020-04-01 ~ 2021-03-31 |
Ralph T Tella | 15 Benenson Dr, Cos Cob, CT 06807 | Physician/surgeon | 2003-10-09 ~ 2004-10-31 |
Ralph J Laguardia | 25 Mai Rd, Amston, CT 06231-1417 | Physician/surgeon | 2019-11-01 ~ 2020-10-31 |
Ralph Prezioso Jr | 136 Windward Pl, Southington, CT 06489 | Physician/surgeon | 2020-07-01 ~ 2021-06-30 |
Ralph L Crum | P. O. Box 40713, Austin, TX 78704 | Physician/surgeon | 2009-10-01 ~ 2010-09-30 |
Ralph R Stephens Jr | 530 Pembroke Ave, Norfolk, VA 23507 | Physician/surgeon | 1995-12-22 ~ 1996-12-31 |
Ralph J Cipriani | 7 Riversville Rd Ste 1, Greenwich, CT 06831-3684 | Physician/surgeon | 2020-09-01 ~ 2021-08-31 |
Ralph L Cavalieri Md | 4 Dearfield Dr, Greenwich, CT 06831 | Physician/surgeon | 2003-07-15 ~ 2004-08-31 |
Ralph A Olson | 230 Park Ave, New York, NY 10169 | Physician/surgeon | 1995-02-14 ~ 1996-01-31 |
Ralph C Hughes | P.o.box 5869, Meridian, MS 39302 | Physician/surgeon | 2008-03-27 ~ 2009-03-31 |
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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).