DOMINIQUE FETERMAN JIMENEZ (Credential# 1673907) is licensed (Resident Physician) with Connecticut Department of Consumer Protection. The license effective date is June 28, 2019. The license expiration date date is June 30, 2022. The license status is ACTIVE.
DOMINIQUE FETERMAN JIMENEZ is licensed with the Department of Consumer Protection of Connecticut. The credential number is #1.063859-RES. The credential type is resident physician. The effective date is June 28, 2019. The expiration date is June 30, 2022. The business address is 263 Farmington Ave, Farmington, CT 06030-0001. The current status is active.
| Licensee Name | DOMINIQUE FETERMAN JIMENEZ |
| Credential ID | 1673907 |
| Credential Number | 1.063859-RES |
| Credential Type | Resident Physician |
| Credential SubCategory | RES |
| Business Address |
263 Farmington Ave Farmington CT 06030-0001 |
| Business Type | INDIVIDUAL |
| Status | ACTIVE - CURRENT |
| Active | 1 |
| Issue Date | 2019-06-28 |
| Effective Date | 2019-06-28 |
| Expiration Date | 2022-06-30 |
| Refresh Date | 2019-07-05 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 1667354 | CSP.0071467 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 2019-07-05 | 2019-07-05 - 2021-02-28 | ACTIVE |
| Street Address | 263 FARMINGTON AVE |
| City | FARMINGTON |
| State | CT |
| Zip Code | 06030-0001 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Erica Shen Nofziger | 263 Farmington Ave, Farmington, CT 06030-0001 | Resident Physician | 2020-07-01 ~ 2027-06-30 |
| Matthew D Goranson | 263 Farmington Ave, Farmington, CT 06030-0001 | Resident Physician | 2020-07-01 ~ 2026-06-30 |
| Jacob Silver | 263 Farmington Ave, Farmington, CT 06030-0001 | Resident Physician | 2020-07-01 ~ 2025-06-30 |
| Nicholas Bellas | 263 Farmington Ave, Farmington, CT 06032-1956 | Resident Physician | 2020-07-01 ~ 2025-06-30 |
| Jennifer Hale | 263 Farmington Ave, Farmington, CT 06030-0001 | Resident Physician | 2020-07-01 ~ 2025-06-30 |
| Cory R Hewitt | 263 Farmington Ave, Farmington, CT 06030-0001 | Resident Physician | 2020-07-01 ~ 2025-06-30 |
| Sango Huwaa Mosia Asante | 263 Farmington Ave, Farmington, CT 06030-0001 | Resident Physician | 2020-07-01 ~ 2025-06-30 |
| Ryan Desrochers | 263 Farmington Ave, Farmington, CT 06030-0001 | Resident Physician | 2020-07-01 ~ 2025-06-30 |
| Kelsey D Greenhalgh | 263 Farmington Ave, Farmington, CT 06030-0001 | Resident Dentist | 2019-07-01 ~ 2025-06-30 |
| Derek J Tow | 263 Farmington Ave, Farmington, CT 06030-0001 | Resident Dentist | 2019-07-01 ~ 2025-06-30 |
| Find all Licenses in the same address | |||
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Wendy A Miller | Mc1921 Farmington Ave # 263, Farmington, CT 06030-0001 | Physician/surgeon | 2020-06-01 ~ 2021-05-31 |
| Jason J Ziegler | 2 Courthouse Square, Farmington, CT 06030-0001 | Real Estate Salesperson | 2020-06-01 ~ 2021-05-31 |
| Bryden T Considine | L2104 of Medicine Rm, Farmington, CT 06030-0001 | Resident Physician | 2017-07-03 ~ 2021-06-30 |
| Dillon Paulo | 4260 Cordoba Ct, Farmington, CT 06030-0001 | Resident Physician | 2020-07-01 ~ 2024-06-30 |
| Omar Ibrahim | 263 Farmington Ave # Mc-1321, Farmington, CT 06030-0001 | Physician/surgeon | 2020-06-01 ~ 2021-05-31 |
| Jillian L Fortier | Uconn Health Center, Department of Surgery, Farmington, CT 06030-0001 | Physician/surgeon | 2020-05-01 ~ 2021-04-30 |
| Douglas Zelisko | 263 Farmington Ave Dept Of, Farmington, CT 06030-0001 | Physician/surgeon | 2020-04-23 ~ 2021-01-31 |
| Ruchir D Trivedi | 263 Farmington Ave # Mc-1405, Farmington, CT 06030-0001 | Physician/surgeon | 2020-06-01 ~ 2021-05-31 |
| Rawan J.j. Sarsour | 263 Farmington Ave # Mc3905, Farmington, CT 06030-0001 | Provisional Faculty Dentist | 2020-04-21 ~ 2021-04-30 |
| Angela Hart | General Medicine- Outpatient Pavilion, Farmington, CT 06030-0001 | Physician/surgeon | 2020-05-01 ~ 2021-04-30 |
| Find all Licenses in zip 06030-0001 | |||
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Eric Anthony Brueckner | 263 Farmington Ave., Farmington, CT 06030 | Physician/surgeon | 2020-08-01 ~ 2021-07-31 |
| Derrick B Bremang | Residency Program, Farmington, CT 06030 | Physician/surgeon | 2020-06-01 ~ 2021-06-30 |
| David M Shafer | Uconn Health Center, Farmington, CT 06030 | Dentist | 2020-07-01 ~ 2021-06-30 |
| Michael J Murphy | Dept of Dermatology, Farmington, CT 06030 | Physician/surgeon | 2020-09-01 ~ 2021-08-31 |
| Richard F Kaplan | Univ. of Ct., Farmington, CT 06030 | Psychologist | 2020-06-01 ~ 2021-05-31 |
| Nicholas George Vitale | 22 Woods Drive, Norwich, CT 06030 | Casino Class I Employee | 2019-12-03 ~ 2020-10-31 |
| Bruce E Gould | Univ of Conn Health Center, Farmington, CT 06030 | Physician/surgeon | 2020-04-01 ~ 2021-03-31 |
| Vinayak M Sathe | Uconn Health Center,263 Farmington Ave, Farmington, CT 06030 | Physician/surgeon | 2020-06-01 ~ 2021-05-31 |
| Shobhana Pathani | Department of Medicine, 263 Farmington Ave, CT 06030 | Physician/surgeon | 2020-06-01 ~ 2021-05-31 |
| Patricia L Almeida | John Dempsey Hospital, Farmington, CT 06030 | Registered Nurse | 2020-04-01 ~ 2021-03-31 |
| Find all Licenses in zip 06030 | |||
| City | FARMINGTON |
| Zip Code | 06030 |
| License Type | Resident Physician |
| License Type + County | Resident Physician + FARMINGTON |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Dominique Dorsainvil | 20 York St., New Haven, CT 06510-3220 | Resident Physician | 2015-06-24 ~ 2021-06-30 |
| Valeria Jimenez | 8820 Sw 132 Pl, Apt 102 D-s, Miami, FL 33186 | Resident Physician | 2019-06-24 ~ 2022-06-30 |
| Valeria Jimenez | 8820 Sw 132nd Pl Apt 102, Miami, FL 33186-1697 | Resident Physician | 2019-06-24 ~ 2022-06-30 |
| D & A Jimenez LLC | 68 Nixon Ave, Naugatuck, CT 06770-4434 | Home Improvement Contractor | 2020-02-10 ~ 2020-11-30 |
| Selvin N Jimenez · Jimenez's Painting | 125 Warsaw St Apt B, Deep River, CT 06417-1629 | Home Improvement Contractor | ~ |
| J Jesus Jimenez · Jimenez Jj Landscaping | 1930 Old Town Rd, Trumbull, CT 06611-4780 | Home Improvement Contractor | 2017-12-01 ~ 2018-11-30 |
| Gina F Lidestri Pa | 4 Dominique Ln, Simsbury, CT 06070-1623 | Physician Assistant | 2020-06-01 ~ 2021-05-31 |
| Sudha M Desai | 2938 Dominique Dr, Galveston, TX 77551 | Physician/surgeon | 1993-07-23 ~ 1994-08-31 |
| Dominique P Harper | 31 Harvest Hill Dr, Trumbull, CT 06611-3939 | Physician Assistant | 2020-05-01 ~ 2021-04-30 |
| Dominique's Biscotti | 1397 Boston Post Rd, Old Saybrook, CT 06475 | Bakery | 2005-02-18 ~ 2005-06-30 |
Please comment or provide details below to improve the information on DOMINIQUE FETERMAN JIMENEZ.
| 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).