CANDI S JUMP
Physician/surgeon


Address: 3131 W Thompson St, Philadelphia, PA 19121-4420

CANDI S JUMP (Credential# 1006778) is licensed (Physician/surgeon) with Connecticut Department of Consumer Protection. The license effective date is August 1, 2012. The license expiration date date is July 31, 2013. The license status is INACTIVE.

Business Overview

CANDI S JUMP is licensed with the Department of Consumer Protection of Connecticut. The credential number is #1.050184-DO. The credential type is physician/surgeon. The effective date is August 1, 2012. The expiration date is July 31, 2013. The business address is 3131 W Thompson St, Philadelphia, PA 19121-4420. The current status is inactive.

Basic Information

Licensee Name CANDI S JUMP
Credential ID 1006778
Credential Number 1.050184-DO
Credential Type Physician/Surgeon
Credential SubCategory DO
Business Address 3131 W Thompson St
Philadelphia
PA 19121-4420
Business Type INDIVIDUAL
Status INACTIVE - LAPSED DUE TO NON-RENEWAL
Issue Date 2011-08-01
Effective Date 2012-08-01
Expiration Date 2013-07-31
Refresh Date 2013-11-06

Office Location

Street Address 3131 W THOMPSON ST
City PHILADELPHIA
State PA
Zip Code 19121-4420

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City PHILADELPHIA
Zip Code 19121
License Type Physician/Surgeon
License Type + County Physician/Surgeon + PHILADELPHIA

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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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