KIMBERLY ANN BUCKNOR (Credential# 2004778) is licensed (Controlled Substance Registration for Practitioner) with Connecticut Department of Consumer Protection. The license effective date is February 3, 2020. The license expiration date date is February 28, 2021. The license status is ACTIVE.
KIMBERLY ANN BUCKNOR is licensed with the Department of Consumer Protection of Connecticut. The credential number is #CSP.0073104. The credential type is controlled substance registration for practitioner. The effective date is February 3, 2020. The expiration date is February 28, 2021. The business address is 3400 B Main Street, Springfield, MA 01199. The current status is active.
| Licensee Name | KIMBERLY ANN BUCKNOR |
| Credential ID | 2004778 |
| Credential Number | CSP.0073104 |
| Credential Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| Business Address |
3400 B Main Street Springfield MA 01199 |
| Business Type | INDIVIDUAL |
| Status | ACTIVE - CURRENT |
| Active | 1 |
| Issue Date | 2020-02-03 |
| Effective Date | 2020-02-03 |
| Expiration Date | 2021-02-28 |
| Refresh Date | 2020-02-04 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 1991605 | 1.064787 | Physician/Surgeon | 2020-01-31 | 2020-01-31 - 2020-11-30 | ACTIVE |
| Street Address | 3400 B MAIN STREET |
| City | SPRINGFIELD |
| State | MA |
| Zip Code | 01199 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Katya Ford · Ivanov | Baystate Medical Center, Springfield, MA 01199 | Physician/surgeon | 2020-06-01 ~ 2021-05-31 |
| Franklin Moore | Departmentt of Pathology, 759 Chestnut St, MA 01199 | Physician/surgeon | 2020-06-01 ~ 2021-05-31 |
| Oren W Johnson | 758 Chestnut Street, Springfield, MA 01199 | Physician/surgeon | 2020-05-01 ~ 2021-04-30 |
| Kelly A Lynch | Baystate Medical Center, Dept. of Obgyn, Springfield, MA 01199 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Orlando L Torres | 140 High Street, Springfield, MA 01199 | Physician/surgeon | 2005-11-21 ~ 2006-07-31 |
| Christopher N Otis | Baystate Medical Center, Springfield, MA 01199 | Physician/surgeon | 2020-05-01 ~ 2021-04-30 |
| Kelly M Tyler | Baystate Medical Center, Springfield, MA 01199 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Neal E Seymour | Baystate Medical Center, Springfield, MA 01199 | Physician/surgeon | 2019-08-01 ~ 2020-07-31 |
| Richard M Engelman | 759 Chestnut St, Springfield, MA 01199 | Physician/surgeon | 2016-11-01 ~ 2017-10-31 |
| Lawrence C Peters | 759 Chestnut St, Springfield, MA 01199 | Physician/surgeon | 2016-08-01 ~ 2017-07-31 |
| Find all Licenses in zip 01199 | |||
| City | SPRINGFIELD |
| Zip Code | 01199 |
| License Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| License Type + County | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER + SPRINGFIELD |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Kimberly A Keegan | 4 Den Rd, New Hartford, CT 06057-3502 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Kimberly J Kempner | 282 Washington St, Hartford, CT 06106-3322 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Kevin Martin Pa | 31 Kimberly Ln, Wethersfield, CT 06109-3994 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Kimberly D Seifert | 20 York St, New Haven, CT 06510-3220 | Controlled Substance Registration for Practitioner | 2019-04-02 ~ 2021-02-28 |
| Kimberly R Robeson | 126 Glenwood Rd, Clinton, CT 06413-1423 | Controlled Substance Registration for Practitioner | 2015-03-01 ~ 2017-02-28 |
| Kimberly W Keefe | 20 York St Tmp 209, New Haven, CT 06510-3220 | Controlled Substance Registration for Practitioner | 2015-03-01 ~ 2017-02-28 |
| Joseph L Dinardo Dmd | 47 Kimberly Dr, Manchester, CT 06040-6842 | Controlled Substance Registration for Practitioner | 2008-03-01 ~ 2009-02-28 |
| Kimberly A Bumbera | 187 Marion Ave, Plantsville, CT 06479-1442 | Controlled Substance Registration for Practitioner | 2019-04-25 ~ 2021-02-28 |
| Kimberly A Hunt | 43b Rita Dr, Bristol, CT 06010-7850 | Controlled Substance Registration for Practitioner | 2015-03-01 ~ 2017-02-28 |
| Kimberly Zeller Md | 8 Cottage St, New Haven, CT 06511 | Controlled Substance Registration for Practitioner | 2003-01-24 ~ 2004-02-28 |
Please comment or provide details below to improve the information on KIMBERLY ANN BUCKNOR.
| 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).