LISA MARIE KODADEK (Credential# 1997505) is licensed (Physician/surgeon) with Connecticut Department of Consumer Protection. The license effective date is April 1, 2020. The license expiration date date is April 30, 2021. The license status is ACTIVE.
LISA MARIE KODADEK is licensed with the Department of Consumer Protection of Connecticut. The credential number is #1.065084. The credential type is physician/surgeon. The effective date is April 1, 2020. The expiration date is April 30, 2021. The business address is 1211 21st Ave S Ste 404, Nashville, TN 37212-2721. The current status is active.
| Licensee Name | LISA MARIE KODADEK |
| Credential ID | 1997505 |
| Credential Number | 1.065084 |
| Credential Type | Physician/Surgeon |
| Business Address |
1211 21st Ave S Ste 404 Nashville TN 37212-2721 |
| Business Type | INDIVIDUAL |
| Status | ACTIVE - CURRENT |
| Active | 1 |
| Issue Date | 2020-04-01 |
| Effective Date | 2020-04-01 |
| Expiration Date | 2021-04-30 |
| Refresh Date | 2020-04-01 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 1997578 | CSP.0072998 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 2020-04-01 | 2020-04-01 - 2021-02-28 | ACTIVE |
| Street Address | 1211 21ST AVE S STE 404 |
| City | NASHVILLE |
| State | TN |
| Zip Code | 37212-2721 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Ramzi Mardam Bey | 2140 Acklen Ave Apt 13, Nashville, TN 37212 | Resident Physician | 2016-09-01 ~ 2021-06-30 |
| Kedron Square Re, LLC | 1616 16th Avenue South, Nashville, TN 37212 | Securities - Coordination | ~ |
| Jose Alberto Arriola Vigo | 1601 23rd Ave S, Nashville, TN 37212 | Physician/surgeon | 2018-06-01 ~ 2019-05-31 |
| Ic Thomasson Assocs | 1612 17th Ave So, Nashville, TN 37212 | Professional Engineer | 1800-12-27 ~ 1991-01-31 |
| John L Ruddy | 2424 Hillsboro Rd Ste 202, Nashville, TN 37212 | Professional Engineer | 2006-02-01 ~ 2007-01-31 |
| Robert L Whitaker | 1025 16th Ave South Ste 400, Nashville, TN 37212 | Professional Engineer | 2003-02-01 ~ 2004-01-31 |
| Band Against Ms Inc. | 54 Music Square East, Suite 350, Nashville, TN 37212 | Public Charity | 2008-03-24 ~ 2009-11-30 |
| Neighbor's Keeper Foundation | 1025 16th Avenue South, Suite 202, Nashville, TN 37212 | Public Charity | 2008-06-01 ~ 2009-05-31 |
| John G Root | 1603c 11th Ave South, Nashville, TN 37212 | Tv & Radio Electronic Technician | 1996-12-12 ~ 1997-08-31 |
| Paul D Moeller Dds | 2620 Ashwood Ave, Nashville, TN 37212 | Dentist | 2012-04-01 ~ 2013-03-31 |
| Find all Licenses in zip 37212 | |||
| City | NASHVILLE |
| Zip Code | 37212 |
| License Type | Physician/Surgeon |
| License Type + County | Physician/Surgeon + NASHVILLE |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Lisa Marie Mengwall-weinstock | 228 Lexington Ave Apt 1, Pittsburgh, PA 15215-3221 | Physician/surgeon | 2020-04-27 ~ 2021-03-31 |
| Ann Marie Schoppmann Pa | 11 Lisa Ln, Woodbridge, CT 06525 | Physician Assistant | 2020-06-01 ~ 2021-05-31 |
| Nicole M Absar | 58 Lisa Ave, Plymouth, MA 02360-5016 | Physician/surgeon | ~ |
| Ana Lisa Carr | Po Box 34457, Omaha, NE 68134-0457 | Physician/surgeon | ~ |
| Lisa J Trencher | 2-11 B Peck Ave, Rye, NY 10580 | Physician/surgeon | 1999-05-20 ~ 2000-05-31 |
| Lisa Das | 26 Tamie Way, Pittsfield, MA 01201 | Physician/surgeon | 2000-01-24 ~ 2001-03-31 |
| Lisa M Bienia Kenton | 4 Fox Run, Sturbridge, MA 01566-1514 | Physician/surgeon | 2020-06-01 ~ 2021-05-31 |
| Lisa M. Fitzgerald | 16 Chauncy St, Cambridge, MA 02138-2439 | Physician/surgeon | 1987-05-01 ~ 1992-05-31 |
| Stewart M. Samuel | 7 Lisa Dr, Dix Hills, NY 11746-5103 | Physician/surgeon | 2019-09-01 ~ 2020-08-31 |
| Lisa M Cannon | 9 Cedar Dr, Danbury, CT 06810 | Physician/surgeon | 1994-11-18 ~ 1995-09-30 |
Please comment or provide details below to improve the information on LISA MARIE KODADEK.
| 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).