MANUEL D TALAVERA
Physician/surgeon


Address: 90-27 Elmhurst Avenue, Jackson Heights, NY 11372

MANUEL D TALAVERA (Credential# 562909) is licensed (Physician/surgeon) with Connecticut Department of Consumer Protection. The license effective date is November 5, 2007. The license expiration date date is December 31, 2008. The license status is INACTIVE.

Business Overview

MANUEL D TALAVERA is licensed with the Department of Consumer Protection of Connecticut. The credential number is #1.045327. The credential type is physician/surgeon. The effective date is November 5, 2007. The expiration date is December 31, 2008. The business address is 90-27 Elmhurst Avenue, Jackson Heights, NY 11372. The current status is inactive.

Basic Information

Licensee Name MANUEL D TALAVERA
Credential ID 562909
Credential Number 1.045327
Credential Type Physician/Surgeon
Business Address 90-27 Elmhurst Avenue
Jackson Heights
NY 11372
Business Type INDIVIDUAL
Status INACTIVE - LAPSED DUE TO NON-RENEWAL
Issue Date 2007-04-30
Effective Date 2007-11-05
Expiration Date 2008-12-31
Refresh Date 2009-07-08

Office Location

Street Address 90-27 Elmhurst Avenue
City Jackson Heights
State NY
Zip Code 11372

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Competitor

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City Jackson Heights
Zip Code 11372
License Type Physician/Surgeon
License Type + County Physician/Surgeon + Jackson Heights

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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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