MICHAEL A CLARK MD (Credential# 353841) 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.
MICHAEL A CLARK MD is licensed with the Department of Consumer Protection of Connecticut. The credential number is #CSP.0034325. 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 850 N Main Street Ext Bldg 2 Ste C2, Wallingford, CT 06492-2400. The current status is active.
| Licensee Name | MICHAEL A CLARK MD |
| Credential ID | 353841 |
| Credential Number | CSP.0034325 |
| Credential Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| Business Address |
850 N Main Street Ext Bldg 2 Ste C2 Wallingford CT 06492-2400 |
| Business Type | INDIVIDUAL |
| Status | ACTIVE - CURRENT |
| Active | 1 |
| Issue Date | 2003-11-18 |
| Effective Date | 2019-03-01 |
| Expiration Date | 2021-02-28 |
| Refresh Date | 2019-02-27 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 559533 | 1.041950 | Physician/Surgeon | 2003-10-30 | 2019-08-01 - 2020-07-31 | ACTIVE |
| 1253636 | CSP.0058977 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | - | PENDING |
| Street Address | 850 N MAIN STREET EXT BLDG 2 STE C2 |
| City | WALLINGFORD |
| State | CT |
| Zip Code | 06492-2400 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Patricia K Buckley | 850 N Main Street Ext, Wallingford, CT 06492-2400 | Acupuncturist | 2020-03-01 ~ 2022-02-28 |
| Clifford A Williams | 850 N Main Street Ext Bldg 2, Wallingford, CT 06492-2400 | Controlled Substance Registration for Practitioner | 2017-03-01 ~ 2019-02-28 |
| Pei F Sun | 850 N Main Street Ext, Wallingford, CT 06492-2400 | Physician/surgeon | 2020-06-01 ~ 2021-05-31 |
| Michael P Gaudio | 850 N Main Street Ext, Wallingford, CT 06492-2400 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Andrea Zola | 53 Alison Ave., Wallingford, CT 06492 | Esthetician | ~ |
| Kyungok Choi | 90 Ward St, Wallingford, CT 06492 | Combination Nail Technician, Esthetician Or Eyelash Technici | ~ |
| Giang Nguyen | 45 Country Club Lane, Wallingford, CT 06492 | Combination Nail Technician, Esthetician Or Eyelash Technici | 2020-06-27 ~ 2021-11-30 |
| Lc Artistry | 207 North Colony Road, Wallingford, CT 06492 | Esthetician | ~ |
| Katie Lee | 20 Angela Dr, Wallingford, CT 06492 | Paramedic | 2020-09-01 ~ 2021-08-31 |
| Vinny's Deli | 567 Center St, Wallingford, CT 06492 | Operator of Weighing & Measuring Devices | 2020-08-01 ~ 2021-07-31 |
| Michele Ruggiero | 26 Leigus Road, Wallingford, CT 06492 | Radiographer | 2020-07-01 ~ 2021-06-30 |
| Dianna K Ball | 104 Simpson Ave, Wallingford, CT 06492 | Speech and Language Pathologist | 2020-08-01 ~ 2021-07-31 |
| Ann Marie Richardson | 20 Mohawk Drive, Wallingford, CT 06492 | Registered Nurse | 2020-07-01 ~ 2021-06-30 |
| Joann Hummel | 60 Deer Run Road, Wallingford, CT 06492 | Medication Administration Certification | 2018-08-21 ~ 2020-08-20 |
| Find all Licenses in zip 06492 | |||
| City | WALLINGFORD |
| Zip Code | 06492 |
| License Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| License Type + County | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER + WALLINGFORD |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Gustav W Anderson Md | 30 Clark Dr, W Hartford, CT 06117 | Controlled Substance Registration for Practitioner | 1993-05-26 ~ 1995-06-01 |
| Kathleen Degen Md | 2 Clark Ave, Branford, CT 06405 | Controlled Substance Registration for Practitioner | 2017-03-01 ~ 2019-02-28 |
| Margaret Mccarthy Dvm | 186 Clark Ave, Branford, CT 06405 | Controlled Substance Registration for Practitioner | 1998-03-01 ~ 1999-02-28 |
| Mitchell B Clark | 800 Summer St, Stamford, CT 06901-1023 | Controlled Substance Registration for Practitioner | 2017-02-01 ~ 2019-02-28 |
| Christopher M Szlezak | 99 Clark St, New Haven, CT 06511-3803 | Controlled Substance Registration for Practitioner | 2013-03-01 ~ 2015-02-28 |
| Randal Zhou | 84 Clark St, New Haven, CT 06511 | Controlled Substance Registration for Practitioner | 2019-07-12 ~ 2021-02-28 |
| S Clark Sugg Md | Norfolk Rd, Litchfield, CT 06759 | Controlled Substance Registration for Practitioner | 2011-03-01 ~ 2013-02-28 |
| Jeffrey M Matheny Md | 220 Clark Ave, Branford, CT 06405 | Controlled Substance Registration for Practitioner | 1999-03-01 ~ 2000-02-28 |
| Charles Licata Do | 625 Clark Ave, Bristol, CT 06010 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Cristiana O Clark | 825 Orange St Fl 2, New Haven, CT 06511-2507 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
Please comment or provide details below to improve the information on MICHAEL A CLARK MD.
| 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).