MAXINE M LEE MD (Credential# 159077) is licensed (Controlled Substance Registration for Practitioner) with Connecticut Department of Consumer Protection. The license effective date is February 29, 2000. The license expiration date date is February 28, 2001. The license status is INACTIVE.
MAXINE M LEE MD is licensed with the Department of Consumer Protection of Connecticut. The credential number is #CSP.0020084. The credential type is controlled substance registration for practitioner. The effective date is February 29, 2000. The expiration date is February 28, 2001. The business address is 5928 Saddleridge Rd, Roanoke, VA 24018. The current status is inactive.
| Licensee Name | MAXINE M LEE MD |
| Credential ID | 159077 |
| Credential Number | CSP.0020084 |
| Credential Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| Business Address |
5928 Saddleridge Rd Roanoke VA 24018 |
| Business Type | INDIVIDUAL |
| Status | INACTIVE |
| Effective Date | 2000-02-29 |
| Expiration Date | 2001-02-28 |
| Refresh Date | 2009-01-26 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 549753 | 1.032118 | Physician/Surgeon | 1992-02-21 | 1999-12-03 - 2000-11-30 | INACTIVE |
| Street Address | 5928 SADDLERIDGE RD |
| City | ROANOKE |
| State | VA |
| Zip Code | 24018 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Khursheed Imam | C/o Advanced Medical Imaging PC, Roanoke, VA 24018 | Physician/surgeon | 2020-03-01 ~ 2021-02-28 |
| Katie Elizabeth Dralle | 5834 Merriman Road, Roanoke, VA 24018 | Registered Nurse | 2019-09-01 ~ 2020-08-31 |
| Melanie Swecker | 3717 Kenwick Trail, Roanoke, VA 24018 | Registered Nurse - Temporary | 2017-07-26 ~ 2017-11-22 |
| Sadaf Ahmed | 4808 Pleasant Hill Drive, Roanoke, VA 24018 | Physician/surgeon | 2016-07-01 ~ 2017-06-30 |
| Thomas B Lutz | 3163 Berry Lane, Apt. 52, Roanoke, VA 24018 | Registered Nurse - Temporary | 2015-09-04 ~ 2016-01-01 |
| Rachel Keville | 3163 Berry Lane Apt 52, Roanoke, VA 24018 | Registered Nurse - Temporary | 2015-08-28 ~ 2015-12-25 |
| Madalina Macrea | 4913 Hunting Hills Court, Roanoke, VA 24018 | Physician/surgeon | 2013-04-01 ~ 2014-03-31 |
| Richard M Wellford | 8370 Martins Creek Rd, Roanoke, VA 24018 | Real Estate Broker | ~ |
| David V Degenhardt | 5119 Elk Hill Drive, Roanoke, VA 24018 | Physician/surgeon | 2009-02-25 ~ 2009-11-30 |
| Jacques C Raymond | 3151 Berry Lane, Roanoke, VA 24018 | Physician/surgeon | 2000-04-07 ~ 2001-03-31 |
| Find all Licenses in zip 24018 | |||
| City | ROANOKE |
| Zip Code | 24018 |
| License Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| License Type + County | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER + ROANOKE |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Maxine C Coore | 49 North St, Hamden, CT 06514 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Sidney Shilberg Dmd | 74 Maxine Road, Bristol, CT 06010 | Controlled Substance Registration for Practitioner | 2011-03-01 ~ 2013-02-28 |
| Maxine Cartwright | 25 Stonehenge Road, Weston, CT 06883 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Maxine Bloom | 14 Bauer Place, Westport, CT 06880-2138 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| C David Bomar Md | 232 Maxine Road, Bristol, CT 06010 | Controlled Substance Registration for Practitioner | 2015-03-01 ~ 2017-02-28 |
| Maxine B. Fischer | 1307 Mill Pond Dr, South Windsor, CT 06074-3551 | Controlled Substance Registration for Practitioner | 2015-03-01 ~ 2017-02-28 |
| 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 |
| Qi Che Md | Bridgeport, CT 06610 | Controlled Substance Registration for Practitioner | 2006-03-01 ~ 2007-02-28 |
| Arundati Rao | CT | 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).