ILYA A BORUCH
Physical Therapist Assistant


Address: 2925 W 5th St Apt 6c, Brooklyn, NY 11224-3917

ILYA A BORUCH (Credential# 980888) is licensed (Physical Therapist Assistant) with Connecticut Department of Consumer Protection. The license effective date is March 24, 2011. The license expiration date date is January 31, 2012. The license status is INACTIVE.

Business Overview

ILYA A BORUCH is licensed with the Department of Consumer Protection of Connecticut. The credential number is #63.001155. The credential type is physical therapist assistant. The effective date is March 24, 2011. The expiration date is January 31, 2012. The business address is 2925 W 5th St Apt 6c, Brooklyn, NY 11224-3917. The current status is inactive.

Basic Information

Licensee Name ILYA A BORUCH
Credential ID 980888
Credential Number 63.001155
Credential Type Physical Therapist Assistant
Business Address 2925 W 5th St Apt 6c
Brooklyn
NY 11224-3917
Business Type INDIVIDUAL
Status INACTIVE - LAPSED DUE TO NON-RENEWAL
Issue Date 2011-03-24
Effective Date 2011-03-24
Expiration Date 2012-01-31
Refresh Date 2014-07-24

Other licenses

ID Credential Code Credential Type Issue Term Status
903840 14 Physical Therapist - EXPIRED APPLICATION

Office Location

Street Address 2925 W 5TH ST APT 6C
City BROOKLYN
State NY
Zip Code 11224-3917

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City BROOKLYN
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License Type Physical Therapist Assistant
License Type + County Physical Therapist Assistant + BROOKLYN

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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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