THEODORE JOHNSON (Credential# 540377) is licensed (Physician/surgeon) with Connecticut Department of Consumer Protection. The license effective date is July 1, 2017. The license expiration date date is June 30, 2018. The license status is INACTIVE.
THEODORE JOHNSON is licensed with the Department of Consumer Protection of Connecticut. The credential number is #1.012538. The credential type is physician/surgeon. The effective date is July 1, 2017. The expiration date is June 30, 2018. The business address is 310 Seabury Dr, Bloomfield, CT 06002-2657. The current status is inactive.
| Licensee Name | THEODORE JOHNSON |
| Credential ID | 540377 |
| Credential Number | 1.012538 |
| Credential Type | Physician/Surgeon |
| Business Address |
310 Seabury Dr Bloomfield CT 06002-2657 |
| Business Type | INDIVIDUAL |
| Status | INACTIVE - LAPSED DUE TO NON-RENEWAL |
| Issue Date | 1966-04-29 |
| Effective Date | 2017-07-01 |
| Expiration Date | 2018-06-30 |
| Refresh Date | 2018-10-03 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 143789 | CSP.0007631 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 2013-03-01 - 2015-02-28 | INACTIVE |
| Street Address | 310 SEABURY DR |
| City | BLOOMFIELD |
| State | CT |
| Zip Code | 06002-2657 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Paula L Raines | 92 Daniel Blvd, Bloomfield, CT 06002 | Licensed Practical Nurse | 2020-07-01 ~ 2021-06-30 |
| Kesone Taletia Telfer | 36 Walsh Street, Bloomfield, CT 06002 | Advanced Practice Registered Nurse | ~ |
| Joan Zito Upton | 106 Duncaster Road, Bloomfield, CT 06002 | Dental Hygienist | 2020-08-01 ~ 2021-07-31 |
| Sheri M Sparks | Primary Eye Care Center, Bloomfield, CT 06002 | Optometrist | 2020-09-01 ~ 2021-08-31 |
| Kaman Aerospace Corporation | Old Windsor Road, Bloomfield, CT 06002 | Operator of Weighing & Measuring Devices | 2020-08-01 ~ 2021-07-31 |
| Healing Meals Foundation Corporation | Po Box 7223, Bloomfield, CT 06002 | Public Charity | 2020-12-01 ~ 2021-11-30 |
| Taylor A West | 5 Tiffany Ln, Bloomfield, CT 06002 | Registered Nurse | 2020-07-01 ~ 2021-06-30 |
| Emma J Ranel | 53 Burr Road, Bloomfield, CT 06002 | Licensed Practical Nurse | 2020-07-01 ~ 2021-06-30 |
| Dorothy W Field | 177 Oliver Way, Bloomfield, CT 06002 | Registered Nurse | 2020-09-01 ~ 2021-08-31 |
| Carol J Mortensen | 6 Maple Edge Dr, Bloomfield, CT 06002 | Registered Nurse | 2020-07-01 ~ 2021-06-30 |
| Find all Licenses in zip 06002 | |||
| City | BLOOMFIELD |
| Zip Code | 06002 |
| License Type | Physician/Surgeon |
| License Type + County | Physician/Surgeon + BLOOMFIELD |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Theodore Nowakiwskys | CT | Physician/surgeon | ~ |
| Theodore Maron | 7 Wildwood Med Ctr, Essex, CT 06426 | Physician/surgeon | 2006-01-26 ~ 2007-03-31 |
| Theodore J Degroot | 53 Lafayette St, Norwich, CT 06360 | Physician/surgeon | 1996-10-28 ~ 1997-12-31 |
| Theodore Rubin | 175 East 62 St, New York, NY 10021 | Physician/surgeon | 2009-03-05 ~ 2010-04-30 |
| Theodore D Fishman Md | 670 Prospect Ave, Hartford, CT 06105 | Physician/surgeon | 2020-06-01 ~ 2021-05-31 |
| Theodore A. Monitz | 285 Boulevard Ne, Atlanta, GA 30312-4205 | Physician/surgeon | 1984-04-26 ~ 1989-04-30 |
| Theodore T Miller | 535 E 70th St, New York, NY 10021-4823 | Physician/surgeon | 2020-04-01 ~ 2021-03-31 |
| Theodore Lidz | 60 Orchard Rd, Woodbridge, CT 06525 | Physician/surgeon | 1995-02-07 ~ 1996-04-30 |
| Theodore H Schettler | 124 Peterborough St, Boston, MA 02215 | Physician/surgeon | 1996-07-22 ~ 1997-07-31 |
| Theodore J Krawiec | 39 Crane Hill Rd, Suffield, CT 06078-1502 | Physician/surgeon | 2020-03-01 ~ 2021-02-28 |
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| 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).