MARY L NEWPORT
Physician/surgeon


Address: 22 Avonridge, Avon, CT 06001

MARY L NEWPORT (Credential# 550590) is licensed (Physician/surgeon) with Connecticut Department of Consumer Protection. The license effective date is February 1, 2011. The license expiration date date is January 31, 2012. The license status is INACTIVE.

Business Overview

MARY L NEWPORT is licensed with the Department of Consumer Protection of Connecticut. The credential number is #1.032991. The credential type is physician/surgeon. The effective date is February 1, 2011. The expiration date is January 31, 2012. The business address is 22 Avonridge, Avon, CT 06001. The current status is inactive.

Basic Information

Licensee Name MARY L NEWPORT
Credential ID 550590
Credential Number 1.032991
Credential Type Physician/Surgeon
Business Address 22 Avonridge
Avon
CT 06001
Business Type INDIVIDUAL
Status INACTIVE - LAPSED DUE TO NON-RENEWAL
Issue Date 1993-05-28
Effective Date 2011-02-01
Expiration Date 2012-01-31
Refresh Date 2012-05-02

Other licenses

ID Credential Code Credential Type Issue Term Status
163049 CSP.0021047 CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER 2005-03-01 2006-03-01 - 2007-02-28 INACTIVE

Office Location

Street Address 22 Avonridge
City Avon
State CT
Zip Code 06001

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City Avon
Zip Code 06001
License Type Physician/Surgeon
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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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