KALU N AGWU MD
Physician/surgeon


Address: 620 Lenox Ave Apt 15r, New York City, NY 10037

KALU N AGWU MD (Credential# 560363) is licensed (Physician/surgeon) with Connecticut Department of Consumer Protection. The license effective date is March 6, 2006. The license expiration date date is March 31, 2007. The license status is INACTIVE.

Business Overview

KALU N AGWU MD is licensed with the Department of Consumer Protection of Connecticut. The credential number is #1.042781. The credential type is physician/surgeon. The effective date is March 6, 2006. The expiration date is March 31, 2007. The business address is 620 Lenox Ave Apt 15r, New York City, NY 10037. The current status is inactive.

Basic Information

Licensee Name KALU N AGWU MD
Credential ID 560363
Credential Number 1.042781
Credential Type Physician/Surgeon
Business Address 620 Lenox Ave Apt 15r
New York City
NY 10037
Business Type INDIVIDUAL
Status INACTIVE - LAPSED DUE TO NON-RENEWAL
Issue Date 2004-09-03
Effective Date 2006-03-06
Expiration Date 2007-03-31
Refresh Date 2009-07-11

Other licenses

ID Credential Code Credential Type Issue Term Status
384878 CSP.0036535 CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER 2004-09-28 2006-03-01 - 2007-02-28 INACTIVE

Office Location

Street Address 620 LENOX AVE APT 15R
City NEW YORK CITY
State NY
Zip Code 10037

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City NEW YORK CITY
Zip Code 10037
License Type Physician/Surgeon
License Type + County Physician/Surgeon + NEW YORK CITY

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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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