PHILIP MORAITIS (Credential# 1121116) is licensed (Physician/surgeon) with Connecticut Department of Consumer Protection. The license effective date is May 1, 2016. The license expiration date date is April 30, 2017. The license status is PENDING.
PHILIP MORAITIS is licensed with the Department of Consumer Protection of Connecticut. The credential number is #1.051490. The credential type is physician/surgeon. The effective date is May 1, 2016. The expiration date is April 30, 2017. The business address is 3640 Main St Ste 205, Springfield, MA 01107-1139. The current status is pending.
| Licensee Name | PHILIP MORAITIS |
| Credential ID | 1121116 |
| Credential Number | 1.051490 |
| Credential Type | Physician/Surgeon |
| Business Address |
3640 Main St Ste 205 Springfield MA 01107-1139 |
| Business Type | INDIVIDUAL |
| Status | PENDING - REINSTATEMENT APPLICATION PENDING |
| Issue Date | 2012-11-28 |
| Effective Date | 2016-05-01 |
| Expiration Date | 2017-04-30 |
| Refresh Date | 2018-02-16 |
| Street Address | 3640 MAIN ST STE 205 |
| City | SPRINGFIELD |
| State | MA |
| Zip Code | 01107-1139 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Brian K Bredvik | 3640 Main St Ste 205, Springfield, MA 01107-1139 | Physician/surgeon | 2020-05-01 ~ 2021-04-30 |
| Mark A Jackowitz | 3640 Main St Ste 205, Springfield, MA 01107-1139 | Physician/surgeon | 2020-01-01 ~ 2020-12-31 |
| Gregory J Faust | 3640 Main St Ste 205, Springfield, MA 01107-1139 | Physician/surgeon | 2014-04-01 ~ 2015-03-31 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Susan D Glover | 3640 Main Street, Springfield, MA 01107-1139 | Physician/surgeon | 2020-07-01 ~ 2021-06-30 |
| Phillip S Kick | 3640 Main St Ste 103, Springfield, MA 01107-1139 | Physician/surgeon | 2016-04-01 ~ 2017-03-31 |
| William C Tran | 3640 Main St Ste 103, Springfield, MA 01107-1139 | Physician/surgeon | 2014-08-01 ~ 2015-07-31 |
| Raphael J De Lima | 3640 Main Street, Springfield, MA 01107-1139 | Physician/surgeon | 2008-10-14 ~ 2009-10-31 |
| Mohammad R Mostafavi | 3640 Main St Ste 103, Springfield, MA 01107-1139 | Physician/surgeon | ~ |
| Donald J Sonn | 3640 Main St Ste 103, Springfield, MA 01107-1139 | Physician/surgeon | ~ |
| Alexander M. Berry | 3640 Main St Ste 103, Springfield, MA 01107-1139 | Physician/surgeon | ~ |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Lauren Elizabeth Marshall | 945 Armory St, Springfield, MA 01107 | Physician Assistant | 2020-04-01 ~ 2021-03-31 |
| Jennifer L Fish | 367 Union Street, Springfield, MA 01107 | Hairdresser/cosmetician | ~ |
| Joseph Pagan | 59 Rowland Street, Springfield, MA 01107 | Medication Administration Certification | 2020-04-20 ~ 2022-04-19 |
| Daniel Laguerre | 382 Springfield St, Springfield, MA 01107 | Crane Operator | ~ |
| Kamal Kant Kalia | 2 Medical Center Drive, Springfield, MA 01107 | Physician/surgeon | 2020-03-01 ~ 2021-02-28 |
| Bushee Enterprises LLC | Po Box 1196, Southwick, MA 01107 | Home Improvement Contractor | 2015-12-01 ~ 2016-11-30 |
| B Lopez | 165 Prospect Street, Springfield, MA 01107 | Notary Public Appointment | 2011-10-01 ~ 2016-09-30 |
| Beth C Mcinerny | 260 Ware Road, Belchertown, MA 01107 | Registered Nurse | 2019-12-01 ~ 2020-11-30 |
| Jorge Enrique Rivera | 20 Narragansett Street, Springfield, MA 01107 | Professional Counselor | 2019-10-01 ~ 2020-09-30 |
| Rachael Hynds-decoteau | 22 Candice Cir, Springfield, MA 01107 | Controlled Substance Registration for Practitioner | 2019-09-19 ~ 2021-02-28 |
| Find all Licenses in zip 01107 | |||
| City | SPRINGFIELD |
| Zip Code | 01107 |
| License Type | Physician/Surgeon |
| License Type + County | Physician/Surgeon + SPRINGFIELD |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Philip H Glogover | Aventura, FL 33180 | Physician/surgeon | 2020-02-01 ~ 2021-01-31 |
| Philip B Jensen | Po Box 606, Lincoln, MA 01773-0606 | Physician/surgeon | 2020-05-01 ~ 2021-04-30 |
| Philip N Effron | 8 Urban St, Stamford, CT 06905 | Physician/surgeon | 1992-11-24 ~ 1994-01-31 |
| Philip Bilello | 81 Main St #11 B, Branford, CT 06405 | Physician/surgeon | 1981-01-01 ~ 1993-12-31 |
| Philip T Glynn | 18 Burbank Rd, Longmeadow, MA 01006 | Physician/surgeon | 1991-01-25 ~ 1992-12-31 |
| Philip T Peverada | P.o. Box 185, Glen Cove, ME 04846 | Physician/surgeon | ~ 1994-12-31 |
| Philip A Waldor | 37 Ivy Road, Wilmington, DE 19806 | Physician/surgeon | 2003-04-07 ~ 2004-05-31 |
| Philip Kotch | 9 Declaration Rd, Southbury, CT 06488-3012 | Physician/surgeon | 2019-09-09 ~ 2020-10-31 |
| Philip M Meyers | 710 W 168th St Rm 428, New York, NY 10032-3726 | Physician/surgeon | 2019-05-01 ~ 2020-04-30 |
| Jisha Philip | 1 Horizon Dr Apt 15, Norwalk, CT 06854-2647 | Physician/surgeon | 2016-04-01 ~ 2017-03-31 |
Please comment or provide details below to improve the information on PHILIP MORAITIS.
| 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).