JULLIE W PAN MD (Credential# 475035) is licensed (Controlled Substance Registration for Practitioner) with Connecticut Department of Consumer Protection. The license effective date is March 1, 2017. The license expiration date date is February 28, 2019. The license status is LAPSED.
JULLIE W PAN MD is licensed with the Department of Consumer Protection of Connecticut. The credential number is #CSP.0041674. The credential type is controlled substance registration for practitioner. The effective date is March 1, 2017. The expiration date is February 28, 2019. The business address is 290 Valley Road, Wexford, PA 15090. The current status is lapsed.
| Licensee Name | JULLIE W PAN MD |
| Credential ID | 475035 |
| Credential Number | CSP.0041674 |
| Credential Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| Business Address |
290 Valley Road Wexford PA 15090 |
| Business Type | INDIVIDUAL |
| Status | LAPSED |
| Active | 1 |
| Issue Date | 2007-06-29 |
| Effective Date | 2017-03-01 |
| Expiration Date | 2019-02-28 |
| Refresh Date | 2019-03-06 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 562323 | 1.044741 | Physician/Surgeon | 2006-09-01 | 2014-10-01 - 2015-09-30 | INACTIVE |
| Street Address | 290 Valley Road |
| City | Wexford |
| State | PA |
| Zip Code | 15090 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Coeptis Pharmaceuticals Inc · Coeptis Pharmaceuticals, Inc | 105 Bradford Rd Ste# 420, Wexford, PA 15090 | Wholesaler of Drugs, Cosmetics & Medical Devices | 2020-07-01 ~ 2021-06-30 |
| Ronald D Martin | 240 Emmett Rd, Wexford, PA 15090 | Pharmacist | 2020-02-01 ~ 2022-01-31 |
| Angela D Nikitas | 423 Fairmont Drive, Wexford, PA 15090 | Pharmacist | 2020-02-01 ~ 2022-01-31 |
| Annette Jeanne English | 135 Blue Heron Drive, Wexford, PA 15090 | Pharmacist | 2020-02-01 ~ 2022-01-31 |
| Trang Mai | 318 Marshall Heights Dr, Wexford, PA 15090 | Pharmacist | 2020-02-01 ~ 2022-01-31 |
| Vasudha Kale | 10596 Forest Hill Dr, Wexford, PA 15090 | Physician/surgeon | 2019-12-01 ~ 2020-11-30 |
| Jeremy A Kriner | 100 Greenwood Drive, Wexford, PA 15090 | Advanced Practice Registered Nurse | 2019-11-01 ~ 2020-10-31 |
| Corey Pacek | 7500 Brooktree Rd., Wexford, PA 15090 | Physician/surgeon | 2019-07-01 ~ 2020-06-30 |
| William E. Saar | 7500 Brooktree Road, Wexford, PA 15090 | Physician/surgeon | 2019-07-01 ~ 2020-06-30 |
| Trenton M Gause | Tri Rivers Consulting, Wexford, PA 15090 | Physician/surgeon | 2019-05-01 ~ 2020-04-30 |
| Find all Licenses in zip 15090 | |||
| City | Wexford |
| Zip Code | 15090 |
| License Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| License Type + County | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER + Wexford |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Yale University Oehs · Jullie W Pan Md Phd | 135 College St 1st Floor, New Haven, CT 06510 | Controlled Substance Laboratory | 2009-04-01 ~ 2010-01-31 |
| Steven Kassels Md · Community Substance Abuse Center | Comm. Physicians PC/125 North Elm Street, Westfield, MA 01085 | Controlled Substance Registration for Practitioner | 2018-06-15 ~ 2019-02-28 |
| Shu-i Lin | CT | Controlled Substance Registration for Practitioner | 2017-06-12 ~ 2019-02-28 |
| Min Jin Kim | 639 4th Ave Apt 5c, Brooklyn, NY 11232-1048 | Controlled Substance Registration for Practitioner | 2012-05-10 ~ 2013-02-28 |
| Erin K Fee | CT | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Huu Duc D Luu | 630 Mix Ave Apt 6p, Hamden, CT 06514-2320 | Controlled Substance Registration for Practitioner | 2011-03-01 ~ 2013-02-28 |
| Arundati Rao | CT | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Qi Che Md | Bridgeport, CT 06610 | Controlled Substance Registration for Practitioner | 2006-03-01 ~ 2007-02-28 |
| Hae J Kim Pa | New Haven, CT 06511 | Controlled Substance Registration for Practitioner | 2008-03-31 ~ 2009-02-28 |
| Kit I Ho | 15 Orange St # 403, New Haven, CT 06510-3317 | Controlled Substance Registration for Practitioner | 2017-03-01 ~ 2019-02-28 |
Please comment or provide details below to improve the information on JULLIE W PAN 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).