EARLE SMITH COLLUM (Credential# 1611838) is licensed (Physician/surgeon) with Connecticut Department of Consumer Protection. The license effective date is July 27, 1981. The license expiration date date is March 31, 1983. The license status is INACTIVE.
EARLE SMITH COLLUM is licensed with the Department of Consumer Protection of Connecticut. The credential number is #1.022968. The credential type is physician/surgeon. The effective date is July 27, 1981. The expiration date is March 31, 1983. The business address is 5005 S 40th St, Phoenix, AZ 85040. The current status is inactive.
| Licensee Name | EARLE SMITH COLLUM |
| Credential ID | 1611838 |
| Credential Number | 1.022968 |
| Credential Type | Physician/Surgeon |
| Business Address |
5005 S 40th St Phoenix AZ 85040 |
| Business Type | INDIVIDUAL |
| Status | INACTIVE - LAPSED DUE TO NON-RENEWAL |
| Issue Date | 1981-07-27 |
| Effective Date | 1981-07-27 |
| Expiration Date | 1983-03-31 |
| Refresh Date | 2018-10-31 |
| Street Address | 5005 S 40th St |
| City | Phoenix |
| State | AZ |
| Zip Code | 85040 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Qingmei Xie | 4207 E. Cotton Center Blvd, Phoenix, AZ 85040 | Physician/surgeon | 2020-01-01 ~ 2020-12-31 |
| Angela R Mcguire | 4610 S. 44th Place, Phoenix, AZ 85040 | Physician/surgeon | 2020-02-01 ~ 2021-01-31 |
| Gravity Pharmaceuticals Inc | 4050 E Cotton Center Blvd Ste 60, Phoenix, AZ 85040 | Wholesaler of Drugs, Cosmetics & Medical Devices | 2017-07-31 ~ 2018-06-30 |
| Dana J Gant | 2133 E. Sunland Ave, Phoenix, AZ 85040 | Registered Nurse | 2016-07-01 ~ 2017-06-30 |
| Tara L Konturas · Tartaglia | 4520 E Baseline, Phoenix, AZ 85040 | Registered Nurse | 1998-08-25 ~ 1999-05-31 |
| Physicians Formulary International · John S Discerni | 3501 East Broadway Rd, Phoenix, AZ 85040 | Wholesaler of Drugs, Cosmetics & Medical Devices | 2000-09-07 ~ 2001-06-30 |
| Arizona Health & Med Specialties | 3801 East Roeser Rd #9, Phoenix, AZ 85040 | Wholesaler of Drugs, Cosmetics & Medical Devices | 1996-08-28 ~ 1997-06-30 |
| Caremark | 4121 East Cotton Center Boulevard, Phoenix, AZ 85040 | Nonresident Pharmacy | 2007-09-01 ~ 2008-08-31 |
| Bottled Water Images · Bottled Water Images LLC | 3910 E Wier Ave, Phoenix, AZ 85040 | Non-alcoholic Beverage & Water Bottlers | ~ |
| Priority Healthcare Corporation | 3501 E Broadway Rd, Phoenix, AZ 85040 | Wholesaler of Drugs, Cosmetics & Medical Devices | 2001-06-01 ~ 2002-06-30 |
| Find all Licenses in zip 85040 | |||
| City | Phoenix |
| Zip Code | 85040 |
| License Type | Physician/Surgeon |
| License Type + County | Physician/Surgeon + Phoenix |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Rex K Collum · Collum & Co | 83 Church Hill Rd, Washington, CT 06793 | Home Improvement Contractor | 2007-12-01 ~ 2008-11-30 |
| Earle Smith Jr | Yale New Haven Hospital, New Haven, CT | Physician/surgeon | 1981-07-27 ~ 1983-03-31 |
| Karen A Collum · Collum Painting IIi | 74 Scott Pl, Brewster, NY 10509-4103 | Home Improvement Contractor | 2014-10-10 ~ 2015-11-30 |
| Pamela Charney Md | 15 Earle Pl, New Rochelle, NY 10801-2016 | Physician/surgeon | 2008-04-21 ~ 2009-03-31 |
| Jonathan S Earle | 53 Highwood Rd, Farmington, CT 06032-1023 | Physician/surgeon | 2019-12-01 ~ 2020-11-30 |
| Earle A Herbert | 10 Seaton Ct, Sugarland, TX 77479 | Physician/surgeon | 1997-11-05 ~ 1998-11-30 |
| Earle J Sittambalam | 155 Windermere Avenue, Ellington, CT 06029 | Physician/surgeon | 2014-09-01 ~ 2015-08-31 |
| Earle W Hayes | 2413 Bayshore Blvd Unit 2305, Tampa, FL 33629-7336 | Physician/surgeon | 2020-02-01 ~ 2021-01-31 |
| Lisa Parker Smith | 29 Earle St, Hartford, CT 06120 | Pharmacy Technician | 2003-07-15 ~ 2004-03-31 |
| Earle L Smith | 23 Ivy Dr, Meriden, CT 06450 | Notary Public Appointment | 1968-05-01 ~ 1973-03-31 |
Please comment or provide details below to improve the information on EARLE SMITH COLLUM.
| 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).