MICHAEL C DUBIK (Credential# 1214493) is licensed (Physician/surgeon) with Connecticut Department of Consumer Protection. The license effective date is November 1, 2016. The license expiration date date is October 31, 2017. The license status is INACTIVE.
MICHAEL C DUBIK is licensed with the Department of Consumer Protection of Connecticut. The credential number is #1.053242. The credential type is physician/surgeon. The effective date is November 1, 2016. The expiration date is October 31, 2017. The business address is 112 Spencer St, Manchester, CT 06040-4601. The current status is inactive.
Licensee Name | MICHAEL C DUBIK |
Credential ID | 1214493 |
Credential Number | 1.053242 |
Credential Type | Physician/Surgeon |
Business Address |
112 Spencer St Manchester CT 06040-4601 |
Business Type | INDIVIDUAL |
Status | INACTIVE - LAPSED DUE TO NON-RENEWAL |
Issue Date | 2014-06-30 |
Effective Date | 2016-11-01 |
Expiration Date | 2017-10-31 |
Refresh Date | 2018-02-03 |
ID | Credential Code | Credential Type | Issue | Term | Status |
---|---|---|---|---|---|
1254603 | CSP.0059008 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 2014-11-13 | 2015-03-01 - 2017-02-28 | INACTIVE |
Street Address | 112 SPENCER ST |
City | MANCHESTER |
State | CT |
Zip Code | 06040-4601 |
Licensee Name | Office Address | Credential | Effective / Expiration |
---|---|---|---|
Richard M Shoup Md | 112 Spencer St, Manchester, CT 06040-4601 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
Sleep Medicine Associates LLC | 112 Spencer St, Manchester, CT 06040-4601 | Wholesaler of Drugs, Cosmetics & Medical Devices | ~ |
Licensee Name | Office Address | Credential | Effective / Expiration |
---|---|---|---|
Mary Fosuah Nketia | 61 Cougar Drive, Manchester, CT 06040 | Registered Nurse | 2020-08-01 ~ 2021-07-31 |
New Seasons Inc. | 164 East Center Street, Manchester, CT 06040 | Public Charity | 2019-06-01 ~ 2020-05-31 |
Kaylen Lam | 60 Chlistone Lane, Manchester, CT 06040 | Combination Nail Technician, Esthetician Or Eyelash Technici | ~ |
Matilde Altamirano | 415 Gardner Street, Manchester, CT 06040 | Nail Technician | 2020-06-27 ~ 2022-04-30 |
Meilan Meilan Chen | 174 Middle Tpke, Manchester, CT 06040 | Nail Technician | ~ |
Prince Acheampong | 32 Bigelow Street, Manchester, CT 06040 | Notary Public Appointment | ~ |
Erin C Boyle | 470 Porter Street, Manchester, CT 06040 | Registered Nurse | 2020-07-01 ~ 2021-06-30 |
Dejone Mitchell | 64 Ruby Dr Apt. P, Manchester, CT 06040 | Combination Nail Technician, Esthetician Or Eyelash Technici | ~ |
Andrea H Clifford | 116 Longview Drive, Manchester, CT 06040 | Licensed Practical Nurse | 2020-09-01 ~ 2021-08-31 |
Tabia Thornton-bey | 103 Walek Farms Road, Manchester, CT 06040 | Licensed Clinical Social Worker | 2020-07-01 ~ 2021-06-30 |
Find all Licenses in zip 06040 |
City | MANCHESTER |
Zip Code | 06040 |
License Type | Physician/Surgeon |
License Type + County | Physician/Surgeon + MANCHESTER |
Licensee Name | Office Address | Credential | Effective / Expiration |
---|---|---|---|
Anna Lesia Dubik | 680 Main Street, Cromwell, CT 06416 | Notary Public Appointment | 2006-02-08 ~ 2011-02-28 |
Michael P Goldman | 15 Elm Pl, Greenwich, CT 06830-6615 | Physician/surgeon | 2020-09-01 ~ 2021-08-31 |
Michael J Lombino | 80 E Putnant Ave, Cos Cob, CT 06807 | Physician/surgeon | 2012-12-01 ~ 2013-11-30 |
Michael E Perkins | 79 Doe Run, Tolland, CT 06084 | Physician/surgeon | 2020-04-01 ~ 2021-03-31 |
Michael Grasso | 3 Keane Ct, Rye, NY 10580-1144 | Physician/surgeon | 2020-06-01 ~ 2021-05-31 |
Michael S Komarow | 755 2nd Ave Fl 2, New York, NY 10017-5977 | Physician/surgeon | 2013-04-01 ~ 2014-03-31 |
Michael F Salvana | P.o.box 233, Lee Center, NY 13363-0233 | Physician/surgeon | 2006-08-11 ~ 2007-08-31 |
Michael L May | P.o. Box 320757, Los Gatos, CA 95032 | Physician/surgeon | 2005-03-28 ~ 2006-04-30 |
Michael J Kelly | Po Box 585, Salisbury, CT 06068-0585 | Physician/surgeon | 2019-09-01 ~ 2020-08-31 |
Michael D Gribetz | Po Box 650, New Hartford, NY 13413-0650 | Physician/surgeon | 2019-11-01 ~ 2020-10-31 |
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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).