LAVERNE D GUGINO
Physician/surgeon


Address: 1119 Summit Avenue, Winthrop, MA 02152-6110

LAVERNE D GUGINO (Credential# 562181) is licensed (Physician/surgeon) with Connecticut Department of Consumer Protection. The license effective date is October 1, 2019. The license expiration date date is September 30, 2020. The license status is ACTIVE.

Business Overview

LAVERNE D GUGINO is licensed with the Department of Consumer Protection of Connecticut. The credential number is #1.044599. The credential type is physician/surgeon. The effective date is October 1, 2019. The expiration date is September 30, 2020. The business address is 1119 Summit Avenue, Winthrop, MA 02152-6110. The current status is active.

Basic Information

Licensee Name LAVERNE D GUGINO
Credential ID 562181
Credential Number 1.044599
Credential Type Physician/Surgeon
Business Address 1119 Summit Avenue
Winthrop
MA 02152-6110
Business Type INDIVIDUAL
Status ACTIVE - CURRENT
Active 1
Issue Date 2006-07-17
Effective Date 2019-10-01
Expiration Date 2020-09-30
Refresh Date 2019-07-19

Office Location

Street Address 1119 Summit Avenue
City Winthrop
State MA
Zip Code 02152-6110

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City Winthrop
Zip Code 02152
License Type Physician/Surgeon
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Laverne M Shary 133 Rye St, Broad Brook, CT 06016 Registered Nurse 1992-10-23 ~ 1993-12-31
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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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