DEREK LEE (Credential# 1519087) is licensed (Resident Physician) with Connecticut Department of Consumer Protection. The license effective date is June 25, 2018. The license expiration date date is July 3, 2022. The license status is ACTIVE.
DEREK LEE is licensed with the Department of Consumer Protection of Connecticut. The credential number is #1.061157-RES. The credential type is resident physician. The effective date is June 25, 2018. The expiration date is July 3, 2022. The business address is 90 S Main St, Middletown, CT 06457-3649. The current status is active.
| Licensee Name | DEREK LEE |
| Credential ID | 1519087 |
| Credential Number | 1.061157-RES |
| Credential Type | Resident Physician |
| Credential SubCategory | RES |
| Business Address |
90 S Main St Middletown CT 06457-3649 |
| Business Type | INDIVIDUAL |
| Status | ACTIVE - CURRENT |
| Active | 1 |
| Issue Date | 2018-06-25 |
| Effective Date | 2018-06-25 |
| Expiration Date | 2022-07-03 |
| Refresh Date | 2018-05-31 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 1528801 | CSP.0068959 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 2018-07-06 | 2019-03-01 - 2021-02-28 | ACTIVE |
| Street Address | 90 S MAIN ST |
| City | MIDDLETOWN |
| State | CT |
| Zip Code | 06457-3649 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Agata K Harabasz | 90 S Main St, Middletown, CT 06457-3649 | Resident Physician | 2020-06-22 ~ 2024-06-27 |
| Erin J Bullough | 90 S Main St, Middletown, CT 06457-3649 | Resident Physician | 2020-06-22 ~ 2024-06-27 |
| Danielle C Hagglund | 90 S Main St, Middletown, CT 06457-3649 | Resident Physician | 2020-06-22 ~ 2024-06-27 |
| Samantha T Morr | 90 S Main St, Middletown, CT 06457-3649 | Resident Physician | 2020-06-22 ~ 2024-06-27 |
| Morgan R Pratt | 90 S Main St, Middletown, CT 06457-3649 | Resident Physician | 2020-06-22 ~ 2024-06-27 |
| Nicholas A Read | 90 S Main St, Middletown, CT 06457-3649 | Resident Physician | 2020-06-22 ~ 2024-06-27 |
| Alison Carini | 90 S Main St, Middletown, CT 06457-3649 | Resident Physician | 2019-06-24 ~ 2023-07-02 |
| Allegra Parrillo | 90 S Main St, Middletown, CT 06457-3649 | Resident Physician | 2018-06-25 ~ 2022-07-03 |
| Jonathan Katz | 90 S Main St, Middletown, CT 06457-3649 | Resident Physician | 2018-06-25 ~ 2022-07-03 |
| Alexandra Carlson | 90 S Main St, Middletown, CT 06457-3649 | Resident Physician | 2018-06-25 ~ 2022-07-03 |
| Find all Licenses in the same address | |||
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Carol J Annino | 173 Fowler Ave, Middletown, CT 06457-3649 | Controlled Substance Registration for Practitioner | 2013-03-01 ~ 2015-02-28 |
| 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 | Resident Physician |
| License Type + County | Resident Physician + MIDDLETOWN |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Derek O Udeh | 20 York St, New Haven, CT 06510 | Resident Physician | 2020-06-11 ~ 2021-06-30 |
| Derek Scherbel | 20 York St, New Haven, CT 06510 | Resident Physician | 2020-06-24 ~ 2021-06-30 |
| Derek Biederman | 1245 Park Ave Apt 6h, New York, NY 10128-1737 | Resident Physician | 2017-07-10 ~ 2019-06-30 |
| Derek Poulin | 263 Farmington Avenue, Farmington, CT 06030-1921 | Resident Physician | 2018-07-01 ~ 2021-06-30 |
| Derek J Tow | 263 Farmington Ave, Farmington, CT 06030-0001 | Resident Dentist | 2019-07-01 ~ 2025-06-30 |
| Derek Soohoo | 145 Huguenot St Ste 610, New Rochelle, NY 10801-5240 | Physician/surgeon | 2019-12-01 ~ 2020-11-30 |
| Derek P Elliott Sr | P.o. Box 162, West Groton, MA 01472 | Physician Assistant | 2005-07-21 ~ 2006-04-30 |
| Derek T. Noel | 53 Brookstone Dr, Sterling, CT 06377-1420 | Physician/surgeon | 2020-02-01 ~ 2021-01-31 |
| Ding-joe Tsai | 10 Derek Ln, Windsor, CT 06095 | Physician/surgeon | 2003-07-18 ~ 2004-09-30 |
| Derek S Bohn | 163 South St #95, Danbury, CT 06810 | Physician/surgeon | 1993-02-25 ~ 1993-10-31 |
Please comment or provide details below to improve the information on DEREK LEE.
| 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).