LESLIE S YOUNGBLOOD
Physical Therapist


Address: 63 Lockhart Ave, Waterbury, CT 06705

LESLIE S YOUNGBLOOD (Credential# 689824) is licensed (Physical Therapist) with Connecticut Department of Consumer Protection. The license effective date is April 21, 1994. The license expiration date date is April 30, 1995. The license status is INACTIVE.

Business Overview

LESLIE S YOUNGBLOOD is licensed with the Department of Consumer Protection of Connecticut. The credential number is #14.004211. The credential type is physical therapist. The effective date is April 21, 1994. The expiration date is April 30, 1995. The business address is 63 Lockhart Ave, Waterbury, CT 06705. The current status is inactive.

Basic Information

Licensee Name LESLIE S YOUNGBLOOD
Credential ID 689824
Credential Number 14.004211
Credential Type Physical Therapist
Business Address 63 Lockhart Ave
Waterbury
CT 06705
Business Type INDIVIDUAL
Status INACTIVE - LAPSED DUE TO NON-RENEWAL
Issue Date 1989-12-13
Effective Date 1994-04-21
Expiration Date 1995-04-30
Refresh Date 2009-07-08

Office Location

Street Address 63 LOCKHART AVE
City WATERBURY
State CT
Zip Code 06705

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City WATERBURY
Zip Code 06705
License Type Physical Therapist
License Type + County Physical Therapist + WATERBURY

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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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