SIMON M CORNELISSEN (Credential# 1263885) is licensed (Physician/surgeon) with Connecticut Department of Consumer Protection. The license effective date is May 1, 2020. The license expiration date date is April 30, 2021. The license status is ACTIVE.
SIMON M CORNELISSEN is licensed with the Department of Consumer Protection of Connecticut. The credential number is #1.053972. The credential type is physician/surgeon. The effective date is May 1, 2020. The expiration date is April 30, 2021. The business address is 45 Balton Rd, Providence, RI 02906. The current status is active.
| Licensee Name | SIMON M CORNELISSEN |
| Credential ID | 1263885 |
| Credential Number | 1.053972 |
| Credential Type | Physician/Surgeon |
| Business Address |
45 Balton Rd Providence RI 02906 |
| Business Type | INDIVIDUAL |
| Status | ACTIVE - CURRENT |
| Active | 1 |
| Issue Date | 2015-04-02 |
| Effective Date | 2020-05-01 |
| Expiration Date | 2021-04-30 |
| Refresh Date | 2020-03-09 |
| Street Address | 45 Balton Rd |
| City | Providence |
| State | RI |
| Zip Code | 02906 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| The Stephen C. Rose Legacy Foundation · The Steve Fund | 138 Governor Street, Providence, RI 02906 | Public Charity | 2020-06-12 ~ 2021-11-30 |
| Moriah Connor | 211 Waterman Street, Unit 20, Providence, RI 02906 | Behavior Analyst | ~ |
| Elizabeth Burns | 198 Camp Street, Providence, RI 02906 | Licensed Clinical Social Worker | ~ |
| Christine Montross | 345 Blackstone Blvd, Providence, RI 02906 | Physician/surgeon | 2020-09-01 ~ 2021-08-31 |
| Susan Dickstein | 196 Freeman Parkway, Providence, RI 02906 | Psychologist | 2020-07-01 ~ 2021-06-30 |
| Victoria S Karlsen | 415 Angell St, Providence, RI 02906 | Behavior Analyst | ~ |
| John W O'bell Md | 14 Rose Ct., Providence, RI 02906 | Physician/surgeon | 2020-06-01 ~ 2021-05-31 |
| Alexandria Hanul Simon | 323 Angell Street, Providence, RI 02906 | Emergency Medical Technician | ~ |
| Molly A Moran | 202 Sixth Street, Providence, RI 02906 | Advanced Practice Registered Nurse | 2020-06-01 ~ 2021-05-31 |
| Sally E Lapides | 63 Manning St, Providence, RI 02906 | Real Estate Broker | 2020-04-01 ~ 2021-03-31 |
| Find all Licenses in zip 02906 | |||
| City | Providence |
| Zip Code | 02906 |
| License Type | Physician/Surgeon |
| License Type + County | Physician/Surgeon + Providence |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| H Joseph Simon | Rt 3 Box 306, Lorena, TX 76655 | Physician/surgeon | 1993-02-25 ~ 1994-03-31 |
| Eric D Simon · Simon and Simon Tilemasters | 425 Geraldine Dr, Coventry, CT 06238 | Home Improvement Contractor | 2006-12-01 ~ 2007-11-30 |
| Frank Cornelissen Contadino Red | Connecticut Brand Registration, Hartford, CT 06106 | Liquor Brand Label | 2017-12-05 ~ 2020-12-03 |
| Frank Cornelissen Munjabel Red | Connecticut Brand Registration, Hartford, CT 06106 | Liquor Brand Label | 2017-12-05 ~ 2020-12-03 |
| Avrom Simon | 128 S. Aberdeen, Chicago, IL 60607 | Physician/surgeon | 2019-12-01 ~ 2020-11-30 |
| Simon J Epstein Md | 60 Northwood Ln, Stamford, CT 06903-4333 | Physician/surgeon | 2020-08-01 ~ 2021-07-31 |
| Beth J Simon | 84 Woodlands Rd, Harrison, NY 10528-1312 | Physician/surgeon | 2020-08-01 ~ 2021-07-31 |
| Thomas J Simon | 129 York St, New Haven, CT 06511 | Physician/surgeon | 1985-10-17 ~ 1987-04-30 |
| Simon Eiref | 29 Village Ln, Bronxville, NY 10708-4805 | Physician/surgeon | 2020-06-05 ~ 2021-04-30 |
| Leonard J Simon | 808 Bronxriver Rd, Bronxville, NY 10708 | Physician/surgeon | 1992-06-25 ~ 1993-06-30 |
Please comment or provide details below to improve the information on SIMON M CORNELISSEN.
| 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).