MALIK J KELLY MD (Credential# 446835) is licensed (Controlled Substance Registration for Practitioner) with Connecticut Department of Consumer Protection. The license effective date is April 21, 2011. The license expiration date date is February 28, 2013. The license status is INACTIVE.
MALIK J KELLY MD is licensed with the Department of Consumer Protection of Connecticut. The credential number is #CSP.0040190. The credential type is controlled substance registration for practitioner. The effective date is April 21, 2011. The expiration date is February 28, 2013. The business address is 9349 Indian Trail Way, Perry Hall, MD 21128-8937. The current status is inactive.
| Licensee Name | MALIK J KELLY MD |
| Credential ID | 446835 |
| Credential Number | CSP.0040190 |
| Credential Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| Business Address |
9349 Indian Trail Way Perry Hall MD 21128-8937 |
| Business Type | INDIVIDUAL |
| Status | INACTIVE |
| Issue Date | 2006-08-24 |
| Effective Date | 2011-04-21 |
| Expiration Date | 2013-02-28 |
| Refresh Date | 2014-01-29 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 562976 | 1.045394 | Physician/Surgeon | 2007-05-09 | 2011-09-01 - 2012-08-31 | INACTIVE |
| 469543 | CSP.0041434 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 2007-06-22 | 2007-06-22 - 2008-02-29 | INACTIVE |
| Street Address | 9349 INDIAN TRAIL WAY |
| City | PERRY HALL |
| State | MD |
| Zip Code | 21128-8937 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Adam Prescott | 4900 Tartan Hill Road, Baltimore, MD 21128 | Registered Nurse | ~ |
| Norbert L Robinson | 5223 East Joppa Road, Perry Hall, MD 21128 | Pharmacist | 2012-02-01 ~ 2014-01-31 |
| Sheena M Joseph | 9507 Kingscroft Ter, Perry Hall, MD 21128 | Registered Nurse | 2012-04-01 ~ 2013-03-31 |
| Lauren M Edmiston | 8201 Featherhill Rd., Perry Hall, MD 21128 | Dietitian/nutritionist | ~ |
| Patricia A Mccarthy | 4426 Carlyn Rd., Perry Hall, MD 21128 | Occupational Therapist | 2001-09-19 ~ 2003-07-31 |
| Katherine R Mcmillan | 9735 Cross Road, Perry Hale, MD 21128 | Veterinarian | 2003-08-01 ~ 2004-08-31 |
| Bruce R Kaufman Jr. | 1204 Westerlee Place, Cantosville, MD 21128 | Paramedic | 2004-10-29 ~ 2005-10-31 |
| Karen E Rastocky · Syska | 4500a Dunton Terrace, Perry Hall, MD 21128 | Hairdresser/cosmetician | 2004-11-16 ~ 2007-01-31 |
| Herminigildo B Fadul | 5108 Crest Haven Way, Perry Hall, MD 21128 | Licensed Practical Nurse | 2005-04-18 ~ 2006-04-30 |
| Emmanuel R Fapohunda | 8629 Silver Lake Drive, Perry Hill, MD 21128 | Pharmacist | 2002-02-11 ~ 2003-01-31 |
| Find all Licenses in zip 21128 | |||
| City | PERRY HALL |
| Zip Code | 21128 |
| License Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| License Type + County | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER + PERRY HALL |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Kiran S Malik | 160 East Ave Apt 3, Norwalk, CT 06851-5715 | Controlled Substance Registration for Practitioner | 2015-03-01 ~ 2017-02-28 |
| Adnan K. Malik | 28 Adirondack Trl, Easton, CT 06612-2050 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Khurram J Malik Md | 87 Grandview Ave, Waterbury, CT 06708-2514 | Controlled Substance Registration for Practitioner | 2009-03-01 ~ 2011-02-28 |
| Amyn Malik | 80 Seymour St, Hartford, CT 06106-3300 | Controlled Substance Registration for Practitioner | 2009-01-05 ~ 2011-02-28 |
| Shrutie Malik | 225 Williamson St, Elizabeth, NJ 07202 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Sajda Malik | 170 Flanders Rd, Niantic, CT 06357-1208 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Awais Malik Md | 754 Clinton Ave, Bridgeport, CT 06604 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Pervaiz A Malik | P.o. Box 9317, Stamford, CT 06904 | Controlled Substance Registration for Practitioner | 1994-03-01 ~ 1996-01-01 |
| Ali Malik | 2800 Main St, Bridgeport, CT 06606 | Controlled Substance Registration for Practitioner | 2019-05-31 ~ 2021-02-28 |
| Malik N Kabir | 5268 Jamesville Rd, Syracuse, NY 13214-2448 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
Please comment or provide details below to improve the information on MALIK J KELLY 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).