WAYNE RALPH BREITWIESER
Physician/surgeon


Address: 6225 4th St, Bloomsburg, PA 17815-8731

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.

Business Overview

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.

Basic Information

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

Office Location

Street Address 6225 4TH ST
City BLOOMSBURG
State PA
Zip Code 17815-8731

Licenses in the same zip code

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
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Competitor

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City BLOOMSBURG
Zip Code 17815
License Type Physician/Surgeon
License Type + County Physician/Surgeon + BLOOMSBURG

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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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