GEORGE COPPA
Physician/surgeon


Address: 112 Jerome Road, Staten Island, NY 10305

GEORGE COPPA (Credential# 546169) is licensed (Physician/surgeon) with Connecticut Department of Consumer Protection. The license effective date is December 12, 2001. The license expiration date date is August 20, 2002. The license status is INACTIVE.

Business Overview

GEORGE COPPA is licensed with the Department of Consumer Protection of Connecticut. The credential number is #1.026754. The credential type is physician/surgeon. The effective date is December 12, 2001. The expiration date is August 20, 2002. The business address is 112 Jerome Road, Staten Island, NY 10305. The current status is inactive.

Basic Information

Licensee Name GEORGE COPPA
Credential ID 546169
Credential Number 1.026754
Credential Type Physician/Surgeon
Business Address 112 Jerome Road
Staten Island
NY 10305
Business Type INDIVIDUAL
Status INACTIVE - REVOKED
Issue Date 1985-08-30
Effective Date 2001-12-12
Expiration Date 2002-08-20
Refresh Date 2009-07-08

Office Location

Street Address 112 JEROME ROAD
City STATEN ISLAND
State NY
Zip Code 10305

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Competitor

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City STATEN ISLAND
Zip Code 10305
License Type Physician/Surgeon
License Type + County Physician/Surgeon + 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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