CHRISTINA Y. KIM (Credential# 1156484) is licensed (Physician/surgeon) with Connecticut Department of Consumer Protection. The license effective date is June 1, 2018. The license expiration date date is May 31, 2019. The license status is INACTIVE.
CHRISTINA Y. KIM is licensed with the Department of Consumer Protection of Connecticut. The credential number is #1.052986. The credential type is physician/surgeon. The effective date is June 1, 2018. The expiration date is May 31, 2019. The business address is 520 Saybrook Rd Fl 1, Middletown, CT 06457-4700. The current status is inactive.
| Licensee Name | CHRISTINA Y. KIM |
| Credential ID | 1156484 |
| Credential Number | 1.052986 |
| Credential Type | Physician/Surgeon |
| Business Address |
520 Saybrook Rd Fl 1 Middletown CT 06457-4700 |
| Business Type | INDIVIDUAL |
| Status | INACTIVE - LAPSED DUE TO NON-RENEWAL |
| Issue Date | 2014-05-01 |
| Effective Date | 2018-06-01 |
| Expiration Date | 2019-05-31 |
| Refresh Date | 2019-09-03 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 1240329 | CSP.0058524 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 2014-08-16 | 2017-03-01 - 2019-02-28 | INACTIVE |
| Street Address | 520 SAYBROOK RD FL 1 |
| City | MIDDLETOWN |
| State | CT |
| Zip Code | 06457-4700 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Tina Roman | 520 Saybrook Rd Ste 250, Middletown, CT 06457-4700 | Physician/surgeon | 2020-07-01 ~ 2021-06-30 |
| Edward G Myer Md | 520 Saybrook Rd Ste 100b, Middletown, CT 06457-4700 | Physician/surgeon | 2020-04-01 ~ 2021-03-31 |
| James M Parker Jr | 540 Saybrook Rd Ste 100, Middletown, CT 06457-4700 | Physician/surgeon | 2020-06-01 ~ 2021-05-31 |
| Root Center for Advanced Recovery | 520 Saybrook Rd Ste 105, Middletown, CT 06457-4700 | Psychiatric Outpatient Clinic | 2019-11-13 ~ 2022-09-30 |
| Dana Ufnal Kivlin | 520 Saybrook Rd, Middletown, CT 06457-4700 | Physician/surgeon | 2020-06-01 ~ 2021-05-31 |
| Brad A Jubelirer | 520 Saybrook Rd Ste 250, Middletown, CT 06457-4700 | Physician/surgeon | 2020-04-01 ~ 2021-03-31 |
| Allison H Whitaker | 520 Saybrook Rd Ste 250, Middletown, CT 06457-4700 | Physician/surgeon | 2020-03-01 ~ 2021-02-28 |
| Timothy C. Siegrist Md | 520 Saybrook Rd, Middletown, CT 06457-4700 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Elizabeth J Northrop | 520 Saybrook Rd Ste 250, Middletown, CT 06457-4700 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Christopher C Lawrence | 520 Saybrook Rd Ste 250, Middletown, CT 06457-4700 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Find all Licenses in zip 06457-4700 | |||
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Elizabeth M Mailhot | 177 Timber Ridge Rd, Middletown, CT 06457 | Dental Hygienist | 2020-08-01 ~ 2021-07-31 |
| Rebecca S Fennessy | 22 Keefe Ln, Middletown, CT 06457 | Licensed Clinical Social Worker | 2020-07-01 ~ 2021-06-30 |
| Eloise M Gagnon | 538 Bow Lane, Middletown, CT 06457 | Hairdresser/cosmetician | 2020-08-01 ~ 2022-07-31 |
| Salvatore Dimauro | 245 Dekoven Dr, Middletown, CT 06457 | Public Weigher | 2020-07-01 ~ 2021-06-30 |
| Frank L Wright | 261 Spencer Dr, Middletown, CT 06457 | Barber | 2020-08-01 ~ 2022-07-31 |
| Gino A Cardella | 50 Sonoma Lane, Middletown, CT 06457 | Real Estate Salesperson | ~ |
| Shannon Lee Mcquillan | 5 Forest Glen Circle, Middletown, CT 06457 | Registered Nurse | 2020-06-26 ~ 2020-09-30 |
| Lori Dimauro · Carta | 244 Chamberlain Hill Road, Middletown, CT 06457 | Hairdresser/cosmetician | 2020-09-01 ~ 2022-08-31 |
| Gail A Corrow | 85 Dora Dr, Middletown, CT 06457 | Real Estate Salesperson | 2020-06-01 ~ 2021-05-31 |
| Mariter V Perez | 8 Moss Glen, Middletown, CT 06457 | Registered Nurse | 2020-08-01 ~ 2021-07-31 |
| Find all Licenses in zip 06457 | |||
| City | MIDDLETOWN |
| Zip Code | 06457 |
| License Type | Physician/Surgeon |
| License Type + County | Physician/Surgeon + MIDDLETOWN |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Christina Bortz | 506 6th St, Brooklyn, NY 11215-3609 | Physician/surgeon | 2018-05-01 ~ 2019-05-31 |
| Christina L Maser Md | 249 Highland St Apt B, New Haven, CT 06511 | Physician/surgeon | 2007-12-26 ~ 2008-12-31 |
| Christina M Mclean | 4 Coach Dr, Old Lyme, CT 06371-1354 | Physician/surgeon | 2020-05-01 ~ 2021-04-30 |
| Christina Bandera Md | 101 Dudley St, Providence, RI 02905-2401 | Physician/surgeon | 2010-09-01 ~ 2011-08-31 |
| Christina Czyrko | 440 New Britain Ave, Plainville, CT 06062-2036 | Physician/surgeon | 2020-08-01 ~ 2021-07-31 |
| Christina E Toufexis | 1 Wahoo Ave, Groton, CT 06349-2324 | Physician/surgeon | ~ 2018-08-31 |
| Christina M Gomez | 20 Anvil Dr, Avon, CT 06001-3201 | Physician/surgeon | 2020-04-01 ~ 2021-03-31 |
| Christina A Herrick Md | 29 Arrowhead Dr, Guilford, CT 06437 | Physician/surgeon | 2014-10-01 ~ 2015-09-30 |
| Christina Antoine | 35 S Hillside Ave, Elmsford, NY 10523-3621 | Physician/surgeon | 2020-08-01 ~ 2021-07-31 |
| Christina M Hift | 42 Sherwood Pl, Greenwich, CT 06830-5638 | Physician/surgeon | 2018-12-01 ~ 2019-11-30 |
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| 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).