KEITH J CHAMPNEY
Physician/surgeon


Address: 17 Ewell Ave, Lexington, MA 02421

KEITH J CHAMPNEY (Credential# 555780) is licensed (Physician/surgeon) with Connecticut Department of Consumer Protection. The license effective date is October 14, 1999. The license expiration date date is August 31, 2000. The license status is INACTIVE.

Business Overview

KEITH J CHAMPNEY is licensed with the Department of Consumer Protection of Connecticut. The credential number is #1.038190. The credential type is physician/surgeon. The effective date is October 14, 1999. The expiration date is August 31, 2000. The business address is 17 Ewell Ave, Lexington, MA 02421. The current status is inactive.

Basic Information

Licensee Name KEITH J CHAMPNEY
Credential ID 555780
Credential Number 1.038190
Credential Type Physician/Surgeon
Business Address 17 Ewell Ave
Lexington
MA 02421
Business Type INDIVIDUAL
Status INACTIVE - LAPSED DUE TO NON-RENEWAL
Issue Date 1999-10-14
Effective Date 1999-10-14
Expiration Date 2000-08-31
Refresh Date 2009-07-08

Office Location

Street Address 17 Ewell Ave
City Lexington
State MA
Zip Code 02421

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John P Marcin 3 Milk Street, Lexington, MA 02421 Distribution System Operator - Class II 2017-04-03 ~ 2020-09-30
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Competitor

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City Lexington
Zip Code 02421
License Type Physician/Surgeon
License Type + County Physician/Surgeon + Lexington

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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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