MIKIAS GEREMEW WOLDE (Credential# 1527770) is licensed (Controlled Substance Registration for Practitioner) with Connecticut Department of Consumer Protection. The license effective date is March 1, 2019. The license expiration date date is February 28, 2021. The license status is INACTIVE.
MIKIAS GEREMEW WOLDE is licensed with the Department of Consumer Protection of Connecticut. The credential number is #CSP.0068885. The credential type is controlled substance registration for practitioner. The effective date is March 1, 2019. The expiration date is February 28, 2021. The business address is 812 Northwest Dr, Silver Spring, MD 20901-1434. The current status is inactive.
| Licensee Name | MIKIAS GEREMEW WOLDE |
| Credential ID | 1527770 |
| Credential Number | CSP.0068885 |
| Credential Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| Business Address |
812 Northwest Dr Silver Spring MD 20901-1434 |
| Business Type | INDIVIDUAL |
| Status | INACTIVE - LACK OF ACTIVE MEDICAL LICENSE |
| Issue Date | 2018-09-11 |
| Effective Date | 2019-03-01 |
| Expiration Date | 2021-02-28 |
| Refresh Date | 2020-04-24 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 1527628 | 23.004263 | Physician Assistant | 2018-09-24 | 2018-11-01 - 2019-10-31 | INACTIVE |
| 1598779 | 23.004235-RES | Resident Physician Assistant | 2018-09-10 | 2018-09-10 - 2019-09-06 | INACTIVE |
| Street Address | 812 NORTHWEST DR |
| City | SILVER SPRING |
| State | MD |
| Zip Code | 20901-1434 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Janet A Brown | 11300 Crescendo Place, Silver Spring, MD 20901 | Registered Nurse | 2019-11-01 ~ 2020-10-31 |
| Jenna C Williams | 100 Snowy Owl Dr., Silver Spring, MD 20901 | Registered Nurse | 2016-05-01 ~ 2017-04-30 |
| George S Ives | 11200 Lockwood Dr Apt 216, Silver Springs, MD 20901 | Professional Engineer | 1990-02-01 ~ 1991-01-31 |
| James E Cummings | 10906 Jarboe Ave, Silver Spring, MD 20901 | Professional Engineer | 1999-02-01 ~ 2000-01-31 |
| Daniel L Patete | 9408 Saybrook Ave, Silver Spring, MD 20901 | Professional Engineer | 2005-04-12 ~ 2006-01-31 |
| Elizabeth A Conry | 113 Eastmoor Drive, Silver Spring, MD 20901 | Registered Nurse | 2012-10-05 ~ 2013-09-30 |
| Christine M Marr | 804 Buckingham Dr, Silver Spring, MD 20901 | Marital and Family Therapist | 2010-02-01 ~ 2011-01-31 |
| Dale A Stewart | 9212 Manchester Rd, Silver Spring, MD 20901 | Architect | 2003-08-01 ~ 2004-07-31 |
| Jonelle M Detlor · Wedeven | 1016 Stirling, Silver Spring, MD 20901 | Physical Therapist | 2000-11-03 ~ 2001-12-31 |
| Heidi K Vigeant | 201 Baden Street, Silver Spring, MD 20901 | Registered Nurse | 1997-03-27 ~ 1998-03-31 |
| Find all Licenses in zip 20901 | |||
| City | SILVER SPRING |
| Zip Code | 20901 |
| License Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| License Type + County | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER + SILVER SPRING |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Steven Kassels Md · Community Substance Abuse Center | Comm. Physicians PC/125 North Elm Street, Westfield, MA 01085 | Controlled Substance Registration for Practitioner | 2018-06-15 ~ 2019-02-28 |
| Shu-i Lin | CT | Controlled Substance Registration for Practitioner | 2017-06-12 ~ 2019-02-28 |
| Min Jin Kim | 639 4th Ave Apt 5c, Brooklyn, NY 11232-1048 | Controlled Substance Registration for Practitioner | 2012-05-10 ~ 2013-02-28 |
| Erin K Fee | CT | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Arundati Rao | CT | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Qi Che Md | Bridgeport, CT 06610 | Controlled Substance Registration for Practitioner | 2006-03-01 ~ 2007-02-28 |
| Huu Duc D Luu | 630 Mix Ave Apt 6p, Hamden, CT 06514-2320 | Controlled Substance Registration for Practitioner | 2011-03-01 ~ 2013-02-28 |
| Hae J Kim Pa | New Haven, CT 06511 | Controlled Substance Registration for Practitioner | 2008-03-31 ~ 2009-02-28 |
| William A Gay | 34 Ten Rod Rd, Voluntown, CT 06384-1726 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Jim G Yu | 24 Hospital Ave, Danbury, CT 06810-6099 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
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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).