AVI MALKIS
Dentist


Address: 34 Groton St, Staten Island, NY 10312-6538

AVI MALKIS (Credential# 1037666) is licensed (Dentist) with Connecticut Department of Consumer Protection. The license effective date is October 1, 2018. The license expiration date date is September 30, 2019. The license status is INACTIVE.

Business Overview

AVI MALKIS is licensed with the Department of Consumer Protection of Connecticut. The credential number is #2.010670. The credential type is dentist. The effective date is October 1, 2018. The expiration date is September 30, 2019. The business address is 34 Groton St, Staten Island, NY 10312-6538. The current status is inactive.

Basic Information

Licensee Name AVI MALKIS
Credential ID 1037666
Credential Number 2.010670
Credential Type Dentist
Business Address 34 Groton St
Staten Island
NY 10312-6538
Business Type INDIVIDUAL
Status INACTIVE - LAPSED DUE TO NON-RENEWAL
Issue Date 2011-11-02
Effective Date 2018-10-01
Expiration Date 2019-09-30
Refresh Date 2020-01-03

Other licenses

ID Credential Code Credential Type Issue Term Status
1054165 CSP.0052057 CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER 2012-03-01 2017-03-01 - 2019-02-28 LAPSED

Office Location

Street Address 34 GROTON ST
City STATEN ISLAND
State NY
Zip Code 10312-6538

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City STATEN ISLAND
Zip Code 10312
License Type Dentist
License Type + County Dentist + STATEN ISLAND

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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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