CHARLES A BUCKNAM MD (Credential# 540375) is licensed (Physician/surgeon) with Connecticut Department of Consumer Protection. The license effective date is June 14, 1999. The license expiration date date is June 30, 2000. The license status is INACTIVE.
CHARLES A BUCKNAM MD is licensed with the Department of Consumer Protection of Connecticut. The credential number is #1.012535. The credential type is physician/surgeon. The effective date is June 14, 1999. The expiration date is June 30, 2000. The business address is 15 Claybar Dr, W Hartford, CT 06117. The current status is inactive.
| Licensee Name | CHARLES A BUCKNAM MD |
| Credential ID | 540375 |
| Credential Number | 1.012535 |
| Credential Type | Physician/Surgeon |
| Business Address |
15 Claybar Dr W Hartford CT 06117 |
| Business Type | INDIVIDUAL |
| Status | INACTIVE - LAPSED DUE TO NON-RENEWAL |
| Issue Date | 1966-05-03 |
| Effective Date | 1999-06-14 |
| Expiration Date | 2000-06-30 |
| Refresh Date | 2009-07-11 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 153397 | CSP.0003631 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 1999-03-01 - 2000-02-28 | INACTIVE |
| Street Address | 15 CLAYBAR DR |
| City | W HARTFORD |
| State | CT |
| Zip Code | 06117 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Cathy Tran | 20 Lindy Lane, West Hartford, CT 06117 | Combination Nail Technician, Esthetician Or Eyelash Technici | ~ |
| Renaissance Craftsmen LLC | 263 Simsbury Road, West Hartford, CT 06117 | Home Improvement Contractor | 2020-06-27 ~ 2020-11-30 |
| Lev Tsarkov | 116 Lyman Road, West Hartford, CT 06117 | Registered Nurse | 2020-06-01 ~ 2021-05-31 |
| Scott Lee Ratchford | 67 Balfour Dr., West Hartford, CT 06117 | Professional Counselor | ~ |
| Gary Neidle | 8 Stratford Rd, West Hartford, CT 06117 | Real Estate Salesperson | 2020-06-26 ~ 2021-05-31 |
| Beverly Vincent | 37 Harwich Lane, West Hartford, CT 06117 | Hairdresser/cosmetician | 2020-07-01 ~ 2022-06-30 |
| Marc D Palter | 94 Beacon Hill Dr, West Hartford, CT 06117 | Physician/surgeon | 2020-07-01 ~ 2021-06-30 |
| David L Friar | 35 Porter Dr, W Hartford, CT 06117 | Architect | 2020-08-01 ~ 2021-07-31 |
| Adlin C Daye | 147 Mohawk Drive, West Hartford, CT 06117 | Real Estate Salesperson | 2020-06-01 ~ 2021-05-31 |
| Derek M Mcdermott | 61 Ferncliff Drive, West Hartford, CT 06117 | Emergency Medical Technician | ~ |
| Find all Licenses in zip 06117 | |||
| City | W HARTFORD |
| Zip Code | 06117 |
| License Type | Physician/Surgeon |
| License Type + County | Physician/Surgeon + W HARTFORD |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Frank G Bucknam | 84 Howe Street, New Haven, CT 06511 | Physician/surgeon | 2015-05-01 ~ 2016-04-30 |
| Charles F Stroebel IIi | Po Box 279, Andover, CT 06232-0279 | Physician/surgeon | 1998-03-16 ~ 1999-05-31 |
| Charles L Larkin Jr | Box 177, Middlebury, CT 06762 | Physician/surgeon | 2006-05-04 ~ 2007-05-31 |
| Charles Flack | Ohs 3rd Fl, San Bernadino, CA 92415 | Physician/surgeon | 1993-09-23 ~ 1994-07-31 |
| Charles A Mauriello | P.o Box 570, Villanova, PA 19085 | Physician/surgeon | 2010-08-01 ~ 2011-07-31 |
| Charles M Dickson | 95 Day St, Granby, CT 06035 | Physician/surgeon | 2010-04-01 ~ 2011-03-31 |
| Christopher El Khuri | 218 N Charles St, Baltimore, MD 21201-4021 | Physician/surgeon | ~ |
| Charles W Boren | Rt 2 Box 106, Pecos, NM 87552 | Physician/surgeon | 1993-05-25 ~ 1994-06-30 |
| Charles Valdez | 412 Franklin Ave., Stratford, CT 06497 | Physician/surgeon | 1987-06-26 ~ 1990-08-31 |
| Charles M Paolino | 206 Kuyper Dr, Nyack, NY 10960-1017 | Physician/surgeon | 2019-11-01 ~ 2020-10-31 |
Please comment or provide details below to improve the information on CHARLES A BUCKNAM 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).