CLARK TAREK KHOLEIF (Credential# 1648974) is licensed (Physician/surgeon) with Connecticut Department of Consumer Protection. The license effective date is November 1, 2019. The license expiration date date is October 31, 2020. The license status is ACTIVE.
CLARK TAREK KHOLEIF is licensed with the Department of Consumer Protection of Connecticut. The credential number is #1.063697. The credential type is physician/surgeon. The effective date is November 1, 2019. The expiration date is October 31, 2020. The business address is 645 E Missouri Ave, Phoenix, AZ 85012. The current status is active.
| Licensee Name | CLARK TAREK KHOLEIF |
| Credential ID | 1648974 |
| Credential Number | 1.063697 |
| Credential Type | Physician/Surgeon |
| Business Address |
645 E Missouri Ave Phoenix AZ 85012 |
| Business Type | INDIVIDUAL |
| Status | ACTIVE - CURRENT |
| Active | 1 |
| Issue Date | 2019-06-14 |
| Effective Date | 2019-11-01 |
| Expiration Date | 2020-10-31 |
| Refresh Date | 2019-09-26 |
| Street Address | 645 E Missouri Ave |
| City | PHOENIX |
| State | AZ |
| Zip Code | 85012 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Macarthur Drake | 645 E Missouri Ave, Phoenix, AZ 85012 | Physician/surgeon | 2020-07-01 ~ 2021-06-30 |
| John E Ditzenberger | 645 E Missouri Ave, Phoenix, AZ 85012 | Physician/surgeon | 2020-07-01 ~ 2021-06-30 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Joel P Helle | 5512 N 2nd St, Phoenix, AZ 85012 | Pharmacist | 2020-02-01 ~ 2022-01-31 |
| Jeffrey Rutz | 411 E. Indian School Road #1024, Phoenix, AZ 85012 | Registered Nurse | 2018-03-01 ~ 2019-02-28 |
| Michael Amico | 5350 N Central Ave, Phoenix, AZ 85012 | Home Improvement Salesperson | 2015-05-06 ~ 2015-11-30 |
| Sullivan-durand Inc. | 6824 N. 4th Place, Pheonix, AZ 85012 | Professional Engineer | 1986-02-07 ~ 1987-01-31 |
| Monique M Allen | 9 East Orange Dr, Phoenix, AZ 85012 | Registered Nurse | ~ 1999-02-28 |
| Carlos E Llanes | 5025 N. Central Ave, Phoenix, AZ 85012 | Dentist | 2004-09-07 ~ 2005-10-31 |
| Deborah S Gilman | Dept of Psychiatry, Phoenix, AZ 85012 | Physician/surgeon | 1992-08-26 ~ 1993-10-31 |
| Kirsten M Cady | 4140 N Central Ave Apt 1015, Phoenix, AZ 85012-1847 | Registered Nurse - Temporary | 2015-12-01 ~ 2016-03-29 |
| Kalyan Raman | Brown & Caldwell, Phoenix, AZ 85012-1931 | Professional Engineer | 2002-03-01 ~ 2003-01-31 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Phoenix Gospel Mission | 1540 W Van Buren St, Phoenix, AZ 85007 | Public Charity | 2019-06-01 ~ 2020-05-31 |
| Marilyn Anne Osterman | 2216 W Berridge Ln, Phoenix, AZ 85015-1930 | Registered Nurse - Temporary | 2020-06-26 ~ 2020-10-24 |
| Nick C King | 2820 E. Acoma Dr, Phoenix, AZ 85032 | Professional Engineer | 2020-06-16 ~ 2021-01-31 |
| Dsquared Pharmaceuticals Inc | 4050 E Cotton Center Blvd Ste 63, Phoenix, AZ 85040-8864 | Wholesaler of Drugs, Cosmetics & Medical Devices | 2020-07-01 ~ 2021-06-30 |
| Marina Mata | 1938 E Mitchell Dr, Phoenix, AZ 85016-6411 | Registered Nurse - Temporary | 2020-06-23 ~ 2020-10-21 |
| William Louis Paluch | 2326 E Clarendon Ave, Phoenix, AZ 85016-6519 | Architect | ~ |
| Niagara Bottling LLC | 275 S 67th Ave, Phoenix, AZ 85043-3427 | Non-alcoholic Beverage & Water Bottlers | 2020-07-01 ~ 2021-06-30 |
| Schuff Steel Company | 3020 E Camelback Rd Ste 100, Phoenix, AZ 85016-4422 | Major Contractor | 2020-07-01 ~ 2021-06-30 |
| Deborah Leigh Ferro | 3007 W Roma Ave, Phoenix, AZ 85017-4150 | Registered Nurse - Temporary | 2020-06-18 ~ 2020-10-16 |
| Richard N Loope | 3138 E San Juan Ave, Phoenix, AZ 85016-3725 | Architect | 2020-08-01 ~ 2021-07-31 |
| Find all Licenses in PHOENIX | |||
| City | PHOENIX |
| Zip Code | 85012 |
| License Type | Physician/Surgeon |
| License Type + County | Physician/Surgeon + PHOENIX |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Tarek R Rashid | 115 Morris St, Jersey City, NJ 07302 | Physician/surgeon | 2020-06-01 ~ 2021-05-31 |
| Tarek Elkady | 10 Arborwood Ln, White Plains, NY 10603 | Physician/surgeon | 2019-10-01 ~ 2020-09-30 |
| Tarek Anjari | 7510 Wetherington Drive, West Chester, OH 45069 | Physician/surgeon | 2020-02-01 ~ 2021-01-31 |
| Nidale Tarek | 1233 York Avenue, New York, NY 10065 | Physician/surgeon | 2010-07-01 ~ 2011-06-30 |
| Tarek Khader | 245 Edwards St, New Haven, CT 06511-3737 | Resident Physician | 2020-07-01 ~ 2021-06-30 |
| R S Briggs Md | 138 Clark Rd, Litchfield, CT 06759 | Physician/surgeon | 2006-12-21 ~ 2007-12-31 |
| Matthew S Clark | Po Box 129, Montrose, NY 10548-0129 | Physician/surgeon | 2019-12-01 ~ 2020-11-30 |
| Ann O Massion Md | 157 Clark St, Worcester, MA 01606 | Physician/surgeon | 2002-04-16 ~ 2003-05-31 |
| Clark E O'brien | P.o. Box 722, West Simsbury, CT 06092 | Physician/surgeon | 2018-11-01 ~ 2019-10-31 |
| Brian J Clark | 1 Caleb Ct, Guilford, CT 06437-2298 | Physician/surgeon | 2020-07-01 ~ 2021-06-30 |
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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).