ANTONINA M SUPPA
Radiographer


Address: 74 - 25 64th Ln, Glendale, NY 11385-6132

ANTONINA M SUPPA (Credential# 944535) is licensed (Radiographer) with Connecticut Department of Consumer Protection. The license effective date is April 1, 2016. The license expiration date date is March 31, 2017. The license status is INACTIVE.

Business Overview

ANTONINA M SUPPA is licensed with the Department of Consumer Protection of Connecticut. The credential number is #28.005874. The credential type is radiographer. The effective date is April 1, 2016. The expiration date is March 31, 2017. The business address is 74 - 25 64th Ln, Glendale, NY 11385-6132. The current status is inactive.

Basic Information

Licensee Name ANTONINA M SUPPA
Credential ID 944535
Credential Number 28.005874
Credential Type Radiographer
Business Address 74 - 25 64th Ln
Glendale
NY 11385-6132
Business Type INDIVIDUAL
Status INACTIVE - LAPSED DUE TO NON-RENEWAL
Issue Date 2010-08-11
Effective Date 2016-04-01
Expiration Date 2017-03-31
Refresh Date 2017-07-04

Office Location

Street Address 74 - 25 64TH LN
City GLENDALE
State NY
Zip Code 11385-6132

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City GLENDALE
Zip Code 11385
License Type Radiographer
License Type + County Radiographer + GLENDALE

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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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