BRUCE MIRVIS (Credential# 1647540) is licensed (Physician/surgeon) with Connecticut Department of Consumer Protection. The license effective date is June 1, 2020. The license expiration date date is May 31, 2021. The license status is ACTIVE.
BRUCE MIRVIS is licensed with the Department of Consumer Protection of Connecticut. The credential number is #1.063885. The credential type is physician/surgeon. The effective date is June 1, 2020. The expiration date is May 31, 2021. The business address is 272 Eastmoor Blvd, Columbus, OH 43209-2020. The current status is active.
| Licensee Name | BRUCE MIRVIS |
| Credential ID | 1647540 |
| Credential Number | 1.063885 |
| Credential Type | Physician/Surgeon |
| Business Address |
272 Eastmoor Blvd Columbus OH 43209-2020 |
| Business Type | INDIVIDUAL |
| Status | ACTIVE - CURRENT |
| Active | 1 |
| Issue Date | 2019-07-09 |
| Effective Date | 2020-06-01 |
| Expiration Date | 2021-05-31 |
| Refresh Date | 2020-06-24 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 1690198 | CSP.0072383 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 2019-09-06 | 2019-09-06 - 2021-02-28 | ACTIVE |
| Street Address | 272 EASTMOOR BLVD |
| City | COLUMBUS |
| State | OH |
| Zip Code | 43209-2020 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Aaron J Stan | 875 Pleasant Ridge Ave, Columbus, OH 43209 | Registered Nurse | 2018-11-01 ~ 2019-10-31 |
| Aylianna Jocelyn Laroche | 2388 E Livingston Ave, Columbus, OH 43209 | Registered Nurse | 2018-10-11 ~ 2019-09-30 |
| Reuven A Clein | 2864 Sherwood Rd, Columbus, OH 43209 | Professional Counselor | 2015-10-01 ~ 2016-09-30 |
| Jeffrey H Walker | 368 Northview Dr, Bexley, OH 43209 | Temporary Certified General Real Estate Appraiser | 2011-05-09 ~ 2011-11-09 |
| John F Bowley | 3131 Broadmoor Avenue, Columbus, OH 43209 | Dentist | 1978-04-03 ~ 1989-11-30 |
| John Reagan | 129 S Drexel Ave, Bexley, OH 43209 | Architect | 2007-08-01 ~ 2008-07-31 |
| Joseph Ben-ari | 2881 Sherwood Road, Columbus, OH 43209 | Pharmacist | ~ |
| George A Jacynycz | 2154 E Main St Ste 302, Columbus, OH 43209 | Temporary Certified General Real Estate Appraiser | 2016-06-24 ~ 2016-12-24 |
| James A Powers | 2154 E Main St Ste 302, Columbus, OH 43209 | Temporary Certified General Real Estate Appraiser | 2016-06-24 ~ 2016-12-24 |
| Edward A Stover | 372 N Ardmore Rd, Columbus, OH 43209-1014 | Perfusionist | 2014-03-17 ~ 2014-04-30 |
| Find all Licenses in zip 43209 | |||
| City | COLUMBUS |
| Zip Code | 43209 |
| License Type | Physician/Surgeon |
| License Type + County | Physician/Surgeon + COLUMBUS |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Bruce Kaster | 345 N Main St, West Hartford, CT 06117-2515 | Physician/surgeon | ~ |
| Bruce Tang | 59 Old Post Rd, Clinton, CT 06413 | Physician/surgeon | 2001-01-16 ~ 2001-04-30 |
| R Bruce Thayer | 28 School St, Enfield, CT 06082 | Physician/surgeon | 1996-02-21 ~ 1997-04-30 |
| Bruce E Stein | 21 Parsons Way, Avon, CT 06001 | Physician/surgeon | 2010-01-01 ~ 2010-12-31 |
| Bruce Champagne | 330 E 38th St, New York, NY 10016 | Physician/surgeon | 1998-04-16 ~ 1999-04-30 |
| Bruce M Molinelli Md | 31 River Road, Cos Cob, CT 06807 | Physician/surgeon | 2020-06-01 ~ 2021-05-31 |
| Bruce S Aldred Md | 651 Gilbert Ave, Hamden, CT 06514 | Physician/surgeon | 1998-12-08 ~ 2000-02-29 |
| Bruce D Oran | 45 E 85th St Apt 9-c, New York, NY 10028-0957 | Physician/surgeon | 2020-04-01 ~ 2021-03-31 |
| Bruce J Rounsaville Md | 400 Prospect St, New Haven, CT 06511 | Physician/surgeon | 2010-06-01 ~ 2011-05-31 |
| Bruce E Englander Md | 16 Winchester Ct, Farmington, CT 06032 | Physician/surgeon | 2010-04-01 ~ 2011-03-31 |
Please comment or provide details below to improve the information on BRUCE MIRVIS.
| 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).