JEREMY M MONTEZ
Physician Assistant


Address: 753 Ladera Street, Pasadena, CA 91104

JEREMY M MONTEZ (Credential# 743395) is licensed (Physician Assistant) with Connecticut Department of Consumer Protection. The license effective date is March 24, 2008. The license expiration date date is March 31, 2009. The license status is INACTIVE.

Business Overview

JEREMY M MONTEZ is licensed with the Department of Consumer Protection of Connecticut. The credential number is #23.001646. The credential type is physician assistant. The effective date is March 24, 2008. The expiration date is March 31, 2009. The business address is 753 Ladera Street, Pasadena, CA 91104. The current status is inactive.

Basic Information

Licensee Name JEREMY M MONTEZ
Credential ID 743395
Credential Number 23.001646
Credential Type Physician Assistant
Business Address 753 Ladera Street
Pasadena
CA 91104
Business Type INDIVIDUAL
Status INACTIVE - LAPSED DUE TO NON-RENEWAL
Issue Date 2005-07-12
Effective Date 2008-03-24
Expiration Date 2009-03-31
Refresh Date 2009-07-08

Office Location

Street Address 753 Ladera Street
City Pasadena
State CA
Zip Code 91104

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City Pasadena
Zip Code 91104
License Type Physician Assistant
License Type + County Physician Assistant + Pasadena

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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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