KATHERINE ILL (Credential# 539890) is licensed (Physician/surgeon) with Connecticut Department of Consumer Protection. The license effective date is January 1, 2010. The license expiration date date is December 31, 2010. The license status is INACTIVE.
KATHERINE ILL is licensed with the Department of Consumer Protection of Connecticut. The credential number is #1.011094. The credential type is physician/surgeon. The effective date is January 1, 2010. The expiration date is December 31, 2010. The business address is 324 Brewster Road, Bristol, CT 06010. The current status is inactive.
| Licensee Name | KATHERINE ILL |
| Credential ID | 539890 |
| Credential Number | 1.011094 |
| Credential Type | Physician/Surgeon |
| Business Address |
324 Brewster Road Bristol CT 06010 |
| Business Type | INDIVIDUAL |
| Status | INACTIVE - LAPSED DUE TO NON-RENEWAL |
| Issue Date | 1962-08-31 |
| Effective Date | 2010-01-01 |
| Expiration Date | 2010-12-31 |
| Refresh Date | 2011-04-04 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 144424 | CSP.0006708 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 1996-11-01 - 1998-02-28 | INACTIVE |
| Street Address | 324 BREWSTER ROAD |
| City | BRISTOL |
| State | CT |
| Zip Code | 06010 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Martin F Ill | 324 Brewster Road, Bristol, CT 06010 | Physician/surgeon | 2007-12-19 ~ 2009-02-28 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Deborah M Dube · Adamaitis | 33 Peck Lane, Bristol, CT 06010 | Licensed Practical Nurse | 2020-07-01 ~ 2021-06-30 |
| Barbara M Williams | 45 Harrison Street, Bristol, CT 06010 | Notary Public Appointment | 2020-08-01 ~ 2025-07-31 |
| Le Bao Linh Nguyen | 229 Silo Rd, Bristol, CT 06010 | Nail Technician | ~ |
| Tara M Chipman | 38 Grove St, Bristol, CT 06010 | Licensed Practical Nurse | 2020-07-01 ~ 2021-06-30 |
| Jaclyn J Brandolini | 424 Emmett St, Bristol, CT 06010 | Registered Nurse | 2020-07-01 ~ 2021-06-30 |
| Hoa Le | 63 Seminary St, Bristol, CT 06010 | Nail Technician | ~ |
| Barbara E Trench | 25 Peacedale St, Bristol, CT 06010 | Hairdresser/cosmetician | 2020-07-01 ~ 2022-06-30 |
| Tisha A Balfour | 379 West Street, Bristol, CT 06010 | Licensed Practical Nurse | 2020-08-01 ~ 2021-07-31 |
| Meredith Rose Martineau | 15 Bishop Street, Bristol, CT 06010 | Master's Level Social Worker - Temporary Permit | 2020-06-26 ~ 2020-09-06 |
| Jaime L Krueger | 130 Garfield Road, Bristol, CT 06010 | Notary Public Appointment | 2020-06-26 ~ 2025-06-30 |
| Find all Licenses in zip 06010 | |||
| City | BRISTOL |
| Zip Code | 06010 |
| License Type | Physician/Surgeon |
| License Type + County | Physician/Surgeon + BRISTOL |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Katherine E Rowan | 360 3rd St Ste 425, San Francisco, CA 94107-2164 | Physician/surgeon | ~ |
| Diane Kim | 65 Katherine Ct, Shelton, CT 06484-4336 | Physician/surgeon | 2020-01-01 ~ 2020-12-31 |
| Katherine M. Jahnes | 21 E 10th St Apt 11d, New York, NY 10003-5922 | Physician/surgeon | ~ |
| Katherine L Harvey | 200 Kennedy Dr, Torrington, CT 06790-3096 | Physician/surgeon | 2020-05-01 ~ 2021-04-30 |
| Katherine Seibert | 21 Milton Ave, Liberty, NY 12754 | Physician/surgeon | 1993-03-24 ~ 1994-03-31 |
| Katherine M Detre | 130 Desoto St, Pittsburgh, PA 15261 | Physician/surgeon | 1995-03-06 ~ 1996-04-30 |
| Katherine Jahnes | 550 First Avenue, New York, NY 10016 | Physician/surgeon | 2019-07-01 ~ 2020-06-30 |
| Katherine Ellen Nori Janosz | 126 5th Ave Fl 2, New York, NY 10011-5631 | Physician/surgeon | ~ |
| Katherine A Schneider Md | 95 Parsons St, Wallingford, CT 06492 | Physician/surgeon | 2008-02-22 ~ 2009-03-31 |
| Katherine H Goodrich Md | 190 Waite St Fl 2, Hamden, CT 06517-2529 | Physician/surgeon | 2010-04-01 ~ 2011-03-31 |
Please comment or provide details below to improve the information on KATHERINE ILL.
| 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).