ANDREW J. ILLIG
Physician/surgeon


Address: 390 1st Ave Apt 9c, New York, NY 10010-6521

ANDREW J. ILLIG (Credential# 1083497) is licensed (Physician/surgeon) with Connecticut Department of Consumer Protection. The license effective date is June 1, 2020. The license expiration date date is May 31, 2021. The license status is ACTIVE.

Business Overview

ANDREW J. ILLIG is licensed with the Department of Consumer Protection of Connecticut. The credential number is #1.051324-DO. The credential type is physician/surgeon. The effective date is June 1, 2020. The expiration date is May 31, 2021. The business address is 390 1st Ave Apt 9c, New York, NY 10010-6521. The current status is active.

Basic Information

Licensee Name ANDREW J. ILLIG
Credential ID 1083497
Credential Number 1.051324-DO
Credential Type Physician/Surgeon
Credential SubCategory DO
Business Address 390 1st Ave Apt 9c
New York
NY 10010-6521
Business Type INDIVIDUAL
Status ACTIVE - CURRENT
Active 1
Issue Date 2012-08-21
Effective Date 2020-06-01
Expiration Date 2021-05-31
Refresh Date 2020-05-04

Other licenses

ID Credential Code Credential Type Issue Term Status
1083439 CSP.0053213 CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER 2012-09-13 2019-03-01 - 2021-02-28 ACTIVE

Office Location

Street Address 390 1ST AVE APT 9C
City NEW YORK
State NY
Zip Code 10010-6521

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City NEW YORK
Zip Code 10010
License Type Physician/Surgeon
License Type + County Physician/Surgeon + NEW YORK

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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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