KIMBERLY A PHILLIPS MD (Credential# 198652) is licensed (Controlled Substance Registration for Practitioner) with Connecticut Department of Consumer Protection. The license effective date is March 1, 2019. The license expiration date date is February 28, 2021. The license status is ACTIVE.
KIMBERLY A PHILLIPS MD is licensed with the Department of Consumer Protection of Connecticut. The credential number is #CSP.0027110. The credential type is controlled substance registration for practitioner. The effective date is March 1, 2019. The expiration date is February 28, 2021. The business address is 3906 Broomsedge Ln, Valrico, FL 33596. The current status is active.
| Licensee Name | KIMBERLY A PHILLIPS MD |
| Credential ID | 198652 |
| Credential Number | CSP.0027110 |
| Credential Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| Business Address |
3906 Broomsedge Ln Valrico FL 33596 |
| Business Type | INDIVIDUAL |
| Status | ACTIVE - CURRENT |
| Active | 1 |
| Issue Date | 1999-03-01 |
| Effective Date | 2019-03-01 |
| Expiration Date | 2021-02-28 |
| Refresh Date | 2019-02-15 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 554550 | 1.036960 | Physician/Surgeon | 1998-06-12 | 2020-02-01 - 2021-01-31 | ACTIVE |
| Street Address | 3906 Broomsedge Ln |
| City | Valrico |
| State | FL |
| Zip Code | 33596 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| James C Mcmahon | 3514 Fox Squirrel La, Valrico, FL 33596 | Registered Nurse | 2020-06-01 ~ 2021-05-31 |
| Rosemarie V Langford | 5443 Burnt Hickory Dr, Valrico, FL 33596 | Registered Nurse | 2020-05-01 ~ 2021-04-30 |
| Donald H Berg | 3904 Turkey Oak Dr, Valrico, FL 33596 | Architect | 2019-08-01 ~ 2020-07-31 |
| Kathy P Moonan-wartman | 3805 South Nine Dr, Valrico, FL 33596 | Licensed Clinical Social Worker | 2014-05-01 ~ 2015-04-30 |
| Sheila A Voyles · Quirk | 2230 Golf Manor Boulevard, Valrico, FL 33596 | Registered Nurse | 2010-04-01 ~ 2011-03-31 |
| Yolanda A Graham | 3707 Kentfield Pl, Valrico, FL 33596 | Real Estate Broker | 2010-04-01 ~ 2011-03-31 |
| Optimum Health Pharmacy LLC | 2920 Lithia Pinecrest Rd Unit D, Valrico, FL 33596-5627 | Nonresident Pharmacy | 2017-09-01 ~ 2018-08-31 |
| William D Bynum | 3912 Penrod Ln, Valrico, FL 33596-6300 | Electrical Limited Journeyperson | ~ |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Colleen Marie Masterson | 515 Crowned Eagle Ct, Valrico, FL 33594-3975 | Registered Nurse | 2020-07-01 ~ 2021-06-30 |
| Justin Nelson Rutledge | 1728 Tallowtree Circle, Valrico, FL 33594 | Registered Nurse | ~ |
| Ignacio P Bayna | 505 Beth Ann St, Valrico, FL 33594 | Plumbing & Piping Unlimited Journeyperson | 2019-11-01 ~ 2020-10-31 |
| Robert D Schlindwein | 1003 Legends Pass Dr, Valrico, FL 33594-3733 | Tv & Radio Antenna Installation & Repair Dealer | ~ |
| Lyvenie Sanon | 901 Arista Blvd, Valrico, FL 33594-6719 | Registered Nurse | 2018-10-10 ~ 2019-02-28 |
| Gary R Crandall | 3608 Cinder Dr, Valrico, FL 33594-6866 | Plumbing & Piping Unlimited Contractor | 1995-10-01 ~ 1996-10-31 |
| Willilam T Romaniello IIi | 3457 Castle Stone Ct, Valrico, FL 33594-3340 | Athletic Trainer | 2015-11-01 ~ 2016-10-31 |
| Lynn T Reynolds | 2803 Commonwealth Ave, Valrico, FL 33594-4785 | Registered Nurse | 2014-09-01 ~ 2015-08-31 |
| Maurice Halle | 1920 Bow Ct, Valrico, FL 33594-3111 | Heating, Piping & Cooling Unlimited Journeyperson | 2012-09-01 ~ 2013-08-31 |
| Susan D Farmer | 1418 Dumont Drive, Valrico, FL 33896 | Registered Nurse | 2012-05-01 ~ 2013-04-30 |
| Find all Licenses in Valrico | |||
| City | Valrico |
| Zip Code | 33596 |
| License Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| License Type + County | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER + Valrico |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Harold E Phillips Md | 365 Montauk Ave, New London, CT 06320-4700 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Preston J Phillips Md | 17 Treadwell St, Hamden, CT 06517 | Controlled Substance Registration for Practitioner | 1997-03-01 ~ 1998-02-28 |
| Aleksandra P Phillips | 64 Robbins St, Waterbury, CT 06708-2613 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Christopher R Phillips Pa | 331 Trail Rd, Fiskdale, MA 01518 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Jordan E Phillips | 5 Perryridge Rd, Greenwich, CT 06830-4608 | Controlled Substance Registration for Practitioner | 2015-03-01 ~ 2017-02-28 |
| Adam T Phillips | 17 Court St, New Haven, CT 06511-6922 | Controlled Substance Registration for Practitioner | 2017-03-01 ~ 2019-02-28 |
| Gail Phillips Lnm | 67 Maple St, Derby, CT 06418 | Controlled Substance Registration for Practitioner | 2003-01-24 ~ 2004-02-28 |
| Megan J Phillips | 339 N Society Rd, Canterbury, CT 06331-1240 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Heather L Phillips | 35 Westwood Cir, Meriden, CT 06450-7253 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Julie Phillips | 282 Washington St, Hartford, CT 06106 | Controlled Substance Registration for Practitioner | 2007-07-16 ~ 2008-02-29 |
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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).