WAYNE O SOUTHWICK (Credential# 539325) is licensed (Physician/surgeon) with Connecticut Department of Consumer Protection. The license effective date is January 10, 2003. The license expiration date date is February 29, 2004. The license status is INACTIVE.
WAYNE O SOUTHWICK is licensed with the Department of Consumer Protection of Connecticut. The credential number is #1.008981. The credential type is physician/surgeon. The effective date is January 10, 2003. The expiration date is February 29, 2004. The business address is Po Box 208071, New Haven, CT 06520-8071. The current status is inactive.
| Licensee Name | WAYNE O SOUTHWICK |
| Credential ID | 539325 |
| Credential Number | 1.008981 |
| Credential Type | Physician/Surgeon |
| Business Address |
Po Box 208071 New Haven CT 06520-8071 |
| Business Type | INDIVIDUAL |
| Status | INACTIVE - LAPSED DUE TO NON-RENEWAL |
| Issue Date | 1958-08-05 |
| Effective Date | 2003-01-10 |
| Expiration Date | 2004-02-29 |
| Refresh Date | 2009-07-08 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 146785 | CSP.0001221 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 2003-03-01 - 2004-02-28 | INACTIVE |
| Street Address | PO BOX 208071 |
| City | NEW HAVEN |
| State | CT |
| Zip Code | 06520-8071 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Marc L Rosen | Po Box 208071, New Haven, CT 06520-8071 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Gary E Friedlaender Md · Yale University | Yale University Dept of Orthopaedics, New Haven, CT 06520-8071 | Physician/surgeon | 2020-06-01 ~ 2021-05-31 |
| Carrie Swigart Md | Dept of Orthopaedics, New Haven, CT 06520-8071 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Joseph Slade Md | Yale Univ Dept of Orthopedics, New Haven, CT 06520-8071 | Controlled Substance Registration for Practitioner | 2009-03-01 ~ 2011-02-28 |
| Joseph F Slade IIi | Yale University, New Haven, CT 06520-8071 | Physician/surgeon | 2010-02-01 ~ 2011-01-31 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Orchestra New England | P.o. Box 200123, New Haven, CT 06520 | Public Charity | 2019-06-01 ~ 2020-05-31 |
| Catherine A Dinauer | 333 Cedar St., Fmb 131, New Haven, CT 06520 | Physician/surgeon | 2020-07-01 ~ 2021-06-30 |
| Kofi Agyare Mensah | 300 Cedar Street, New Haven, CT 06520 | Physician/surgeon | 2020-07-01 ~ 2021-06-30 |
| Kevin Huang | 330 Cedar Street, New Haven, CT 06520 | Physician/surgeon | 2020-08-01 ~ 2021-07-31 |
| Mubdiul Imtiaz Ali | 300 Cedar St, Tac S425, New Haven, CT 06520 | Physician/surgeon | 2020-07-01 ~ 2021-06-30 |
| Dr Akhil Khosla | 300 Cedar St, Tac S425 P.o. Box 208057, New Haven, CT 06520 | Physician/surgeon | 2020-09-01 ~ 2021-08-31 |
| Scott N Gettinger Md | 333 Cedar St-yale Cancer Center, New Haven, CT 06520 | Physician/surgeon | 2020-09-01 ~ 2021-08-31 |
| Lindsay Sarah Mcalpine | Yale -new Haven Hospital, New Haven, CT 06520 | Resident Physician | 2020-07-01 ~ 2021-06-30 |
| Michael Hurwitz | 333 Cedar St Www211, New Haven, CT 06520 | Physician/surgeon | 2020-09-01 ~ 2021-08-31 |
| Patrick M Popiel | Yale University, Department of Ob/gyn, New Haven, CT 06520 | Resident Physician | 2017-07-01 ~ 2021-06-30 |
| Find all Licenses in zip 06520 | |||
| City | NEW HAVEN |
| Zip Code | 06520 |
| License Type | Physician/Surgeon |
| License Type + County | Physician/Surgeon + NEW HAVEN |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Wayne Gilbertie Md · Radiology & Imaging | Wayne Gilbertie, Md, Glastonbury, CT 06033 | Physician/surgeon | 2020-04-01 ~ 2021-03-31 |
| Steven M Southwick | P.o Box 548, Old Lyme, CT 06371 | Physician/surgeon | 2019-05-01 ~ 2020-04-30 |
| James A Cennamo | 13 Grandview St, Southwick, MA 01077 | Physician/surgeon | 1994-02-28 ~ 1995-02-28 |
| Jayson R St. Jacques | 22 Deer Run, Southwick, MA 01077 | Physician/surgeon | 2020-03-01 ~ 2021-02-28 |
| Bruce R Dziura | 39 Lakeview St, Southwick, MA 01077-9610 | Physician/surgeon | 2020-07-01 ~ 2021-06-30 |
| Jerri N Fitzgerald | 72 Davis Road, Southwick, MA 01077 | Physician/surgeon | 2009-02-05 ~ 2010-03-31 |
| Ramachandran Kuppuswamy | 243 Hillside Road, Southwick, MA 01077 | Physician/surgeon | 2018-09-04 ~ 2019-09-30 |
| Jacquelyn R Kimball | 151 Fred Jackson Rd, Southwick, MA 01077-9712 | Physician/surgeon | 2020-05-01 ~ 2021-04-30 |
| Vasundhara G Untawale | 281 Farmingdale Rd, Wayne, NJ 07470-6555 | Physician/surgeon | ~ |
| Wayne M Fong | #27h, New York, NY 10016 | Physician/surgeon | 2019-11-01 ~ 2020-10-31 |
Please comment or provide details below to improve the information on WAYNE O SOUTHWICK.
| 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).