PETER FLUECKIGER (Credential# 1490683) is licensed (Resident Physician) with Connecticut Department of Consumer Protection. The license effective date is July 1, 2017. The license expiration date date is June 30, 2019. The license status is INACTIVE.
PETER FLUECKIGER is licensed with the Department of Consumer Protection of Connecticut. The credential number is #1.058785-RES. The credential type is resident physician. The effective date is July 1, 2017. The expiration date is June 30, 2019. The business address is Wake Forest Baptist Medical Center, Winston Salem, NC 27157-0001. The current status is inactive.
| Licensee Name | PETER FLUECKIGER |
| Credential ID | 1490683 |
| Credential Number | 1.058785-RES |
| Credential Type | Resident Physician |
| Credential SubCategory | RES |
| Business Address |
Wake Forest Baptist Medical Center Winston Salem NC 27157-0001 |
| Business Type | INDIVIDUAL |
| Status | INACTIVE - INACTIVE |
| Issue Date | 2017-07-01 |
| Effective Date | 2017-07-01 |
| Expiration Date | 2019-06-30 |
| Refresh Date | 2019-07-01 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 1403121 | CSP.0064809 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 2017-06-06 | 2017-06-06 - 2019-02-28 | LAPSED |
| 1403341 | 1.056288 | Physician/Surgeon | 2017-03-23 | 2017-03-23 - 2018-03-31 | INACTIVE |
| Street Address | WAKE FOREST BAPTIST MEDICAL CENTER |
| City | WINSTON SALEM |
| State | NC |
| Zip Code | 27157-0001 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Matthew Harry Wong | Medical Center Boulevard, Winston Salem, NC 27157-0001 | Physician/surgeon | 2019-11-01 ~ 2020-10-31 |
| Wake Forest University Health Sciences | Medical Center Blvd, Winston Salem, NC 27157-0001 | Public Charity-exempt From Financial Requirements | 2011-04-25 ~ |
| Wake Forest University Baptist Medical Center · Wake Forest Baptist Health, Wake Forest Baptist Medical Center | Medical Center Boulevard, Winston Salem, NC 27157-0001 | Public Charity-exempt From Financial Requirements | 2016-10-13 ~ |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Kimberly A Isley | Medical Center Blvd., Winsten-salem, NC 27157 | Physical Therapist Assistant | ~ 2006-11-01 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| North American Liaison Bureau Inc · Education Congo | 2216 Elgin Rd, Winston Salem, NC 27103-4423 | Public Charity | 2020-02-04 ~ 2020-05-31 |
| Phillip Ellison | 1170 Chester Rd, Winston Salem, NC 27104-1310 | Registered Nurse | 2020-08-01 ~ 2021-07-31 |
| Amanda Dawn Shore | 381 Dover Drive, Winston Salem, NC 27104 | Registered Nurse | 2020-08-01 ~ 2021-07-31 |
| Meredith Spainhour Triplett | 305 Weavil Rd, Winston Salem, NC 27107-8977 | Registered Nurse | ~ |
| Restorative Medical | 2491 Armstrong Dr, Winston Salem, NC 27103-6813 | Wholesaler of Drugs, Cosmetics & Medical Devices | 2020-07-01 ~ 2021-06-30 |
| Greenleaf Medical Supply LLC | 1409 Plaza West Rd Ste# G, Winston Salem, NC 27103 | Wholesaler of Drugs, Cosmetics & Medical Devices | 2020-07-01 ~ 2021-06-30 |
| Cynthia Victoria Francisco | 111 Berwyn Ct, Winston Salem, NC 27107-2027 | Registered Nurse | 2020-09-01 ~ 2021-08-31 |
| Donna J O'meara · Lyons | 827 Westover Ave, Winston Salem, NC 27104 | Registered Nurse | 2020-09-01 ~ 2021-08-31 |
| Hannah Nations Knight | 313 Bent Oak Dr, Winston Salem, NC 27107-5005 | Registered Nurse | 2020-09-01 ~ 2021-08-31 |
| Brooke Sexton Trogdon | 3820 White Petals Ct, Winston Salem, NC 27107-6052 | Registered Nurse | 2019-01-01 ~ 2019-12-31 |
| Find all Licenses in WINSTON SALEM | |||
| City | WINSTON SALEM |
| Zip Code | 27157 |
| License Type | Resident Physician |
| License Type + County | Resident Physician + WINSTON SALEM |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Peter C Lam | 25 Timberline Dr, Farmington, CT 06032-1745 | Resident Physician | 2017-06-28 ~ 2021-06-30 |
| Peter Lee Zhan | 297 George St Apt 6f, New Haven, CT 06511-6646 | Resident Physician | 2020-07-01 ~ 2021-06-30 |
| Peter P Chen | 47 Turtle Bay Dr, Branford, CT 06405-4974 | Resident Physician | 2017-07-01 ~ 2018-06-30 |
| Peter Tang | 404 E 76th St Apt 31c, New York, NY 10021-1417 | Resident Physician | 2020-07-01 ~ 2021-06-30 |
| Michael Peter Burzynski | 20 York St, New Haven, CT 06510-3220 | Resident Physician | 2020-07-01 ~ 2021-06-30 |
| Peter A Mancini | 14 Faulkner Drive, Guilford, CT 06437-2829 | Resident Physician | 2020-07-01 ~ 2021-06-30 |
| Simon Peter Onderi | 20 York St., New Haven, CT 06510-3220 | Resident Physician | 2017-07-25 ~ 2019-06-30 |
| Luke Peter Legakis | 380 Mather St Apt 2104, Hamden, CT 06514-3155 | Resident Physician | 2020-06-11 ~ 2021-06-30 |
| Peter Grzesik | Yusm - Dept of Anesthesiology, New Haven, CT 06510 | Resident Physician | 2020-08-01 ~ 2021-06-30 |
| Peter Svetlozarov Natov | 297 George St Unit 6-a, New Haven, CT 06511-6620 | Resident Physician | 2020-06-11 ~ 2021-06-30 |
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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).