MASAKO NISHIO
Physician/surgeon


Address: 1811 Bluff Street, Boulder, CO 80304

MASAKO NISHIO (Credential# 553984) is licensed (Physician/surgeon) with Connecticut Department of Consumer Protection. The license effective date is September 18, 2003. The license expiration date date is November 30, 2004. The license status is INACTIVE.

Business Overview

MASAKO NISHIO is licensed with the Department of Consumer Protection of Connecticut. The credential number is #1.036392. The credential type is physician/surgeon. The effective date is September 18, 2003. The expiration date is November 30, 2004. The business address is 1811 Bluff Street, Boulder, CO 80304. The current status is inactive.

Basic Information

Licensee Name MASAKO NISHIO
Credential ID 553984
Credential Number 1.036392
Credential Type Physician/Surgeon
Business Address 1811 Bluff Street
Boulder
CO 80304
Business Type INDIVIDUAL
Status INACTIVE - LAPSED DUE TO NON-RENEWAL
Issue Date 1997-09-19
Effective Date 2003-09-18
Expiration Date 2004-11-30
Refresh Date 2009-07-08

Office Location

Street Address 1811 Bluff Street
City Boulder
State CO
Zip Code 80304

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City Boulder
Zip Code 80304
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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