DIDI SALLOUM
Physician/surgeon


Address: 200 John Olds Drive, Apt 207, Manchester, CT 06040

DIDI SALLOUM (Credential# 556790) is licensed (Physician/surgeon) with Connecticut Department of Consumer Protection. The license effective date is December 28, 2000. The license expiration date date is April 30, 2001. The license status is INACTIVE.

Business Overview

DIDI SALLOUM is licensed with the Department of Consumer Protection of Connecticut. The credential number is #1.039204. The credential type is physician/surgeon. The effective date is December 28, 2000. The expiration date is April 30, 2001. The business address is 200 John Olds Drive, Apt 207, Manchester, CT 06040. The current status is inactive.

Basic Information

Licensee Name DIDI SALLOUM
Credential ID 556790
Credential Number 1.039204
Credential Type Physician/Surgeon
Business Address 200 John Olds Drive, Apt 207
Manchester
CT 06040
Business Type INDIVIDUAL
Status INACTIVE - LAPSED DUE TO NON-RENEWAL
Issue Date 2000-12-28
Effective Date 2000-12-28
Expiration Date 2001-04-30
Refresh Date 2009-07-08

Office Location

Street Address 200 John Olds Drive, Apt 207
City Manchester
State CT
Zip Code 06040

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Andrea H Clifford 116 Longview Drive, Manchester, CT 06040 Licensed Practical Nurse 2020-09-01 ~ 2021-08-31
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Competitor

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City Manchester
Zip Code 06040
License Type Physician/Surgeon
License Type + County Physician/Surgeon + Manchester

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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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