JILL E CLARK MD (Credential# 503501) is licensed (Controlled Substance Registration for Practitioner) with Connecticut Department of Consumer Protection. The license effective date is March 1, 2009. The license expiration date date is February 28, 2011. The license status is INACTIVE.
JILL E CLARK MD is licensed with the Department of Consumer Protection of Connecticut. The credential number is #CSP.0043555. The credential type is controlled substance registration for practitioner. The effective date is March 1, 2009. The expiration date is February 28, 2011. The business address is 4475 Oxford Way, Bountiful, UT 84010-5984. The current status is inactive.
| Licensee Name | JILL E CLARK MD |
| Credential ID | 503501 |
| Credential Number | CSP.0043555 |
| Credential Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| Business Address |
4475 Oxford Way Bountiful UT 84010-5984 |
| Business Type | INDIVIDUAL |
| Status | INACTIVE |
| Issue Date | 2008-05-30 |
| Effective Date | 2009-03-01 |
| Expiration Date | 2011-02-28 |
| Refresh Date | 2013-03-07 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 564019 | 1.046437 | Physician/Surgeon | 2008-04-21 | 2008-10-22 - 2009-10-31 | INACTIVE |
| Street Address | 4475 OXFORD WAY |
| City | BOUNTIFUL |
| State | UT |
| Zip Code | 84010-5984 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Elegant Wood-link Sdn Bhd | Pos 356 Bt4 1/2 Parit Bakar Jalan, Muar Johor/malaysia, 84010 | Manufacturer of Bedding & Upholstered Furniture | 2011-06-06 ~ 2012-04-30 |
| Kathleen F Coover | 145 S. 200 E, Bountiful, UT 84010 | Registered Nurse | 2002-09-03 ~ 2003-07-31 |
| Lucy L Sonntag | 1167 East 1850 S, Bountiful, UT 84010 | Pharmacist | ~ 1996-01-31 |
| Thomas G Smith · Smith Hyatt Architects | 851 San Simeon Way, Bountiful, UT 84010-4230 | Architect | ~ |
| Sarah N Nestlehut | 1525 N Main St Apt 340, Bountiful, UT 84010-6172 | Pharmacist | 2018-10-29 ~ 2020-01-31 |
| Cfk Inc · Prescriptions Plus Pharmacy | 47 E 500 S, Bountiful, UT 84010-6227 | Nonresident Pharmacy | 2015-09-01 ~ 2016-08-31 |
| Daniel P. Lyman | 138 W 2800 S, Bountiful, UT 84010-6447 | Certified Public Accountant Certificate | 2020-01-01 ~ 2020-12-31 |
| City | BOUNTIFUL |
| Zip Code | 84010 |
| License Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| License Type + County | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER + BOUNTIFUL |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Jill L Barron Md | P.o. Box 535, Wilton, CT 06897 | Controlled Substance Registration for Practitioner | 2015-03-01 ~ 2017-02-28 |
| Jill C Rubinstein | 26 Jackson Rd, Hamden, CT 06517-1610 | Controlled Substance Registration for Practitioner | 2017-03-01 ~ 2019-02-28 |
| Sid M Tucker | 29 Jill Rd, Highland Mills, NY 10930-3200 | Controlled Substance Registration for Practitioner | 2019-06-03 ~ 2021-02-28 |
| Jill Park | 19 Woodland St #32, Hartford, CT 06105 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Jill S Sobolewski | 47 Sycamore Dr, Durham, CT 06422-1924 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Jill D Torres | 209 Highview St, Mamaroneck, NY 10543-1114 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Jill L Burnes | Po Box 6243, Wolcott, CT 06716-0243 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Jill C Glazewski | 370 Whitney Ave Apt 1, New Haven, CT 06511 | Controlled Substance Registration for Practitioner | 2004-09-22 ~ 2005-02-28 |
| Jill M Tanner | 88 Flint St, Trumbull, CT 06611-3110 | Controlled Substance Registration for Practitioner | 2017-03-01 ~ 2019-02-28 |
| Jill T Herring | 15 Andy Ln, Guilford, CT 06437-1094 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
Please comment or provide details below to improve the information on JILL E 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).