JONATHAN M GORDON MD (Credential# 542623) is licensed (Physician/surgeon) with Connecticut Department of Consumer Protection. The license effective date is March 1, 2020. The license expiration date date is February 28, 2021. The license status is ACTIVE.
JONATHAN M GORDON MD is licensed with the Department of Consumer Protection of Connecticut. The credential number is #1.017998. The credential type is physician/surgeon. The effective date is March 1, 2020. The expiration date is February 28, 2021. The business address is 96 Great Hill Dr, Bethel, CT 06801-1880. The current status is active.
| Licensee Name | JONATHAN M GORDON MD |
| Credential ID | 542623 |
| Credential Number | 1.017998 |
| Credential Type | Physician/Surgeon |
| Business Address |
96 Great Hill Dr Bethel CT 06801-1880 |
| Business Type | INDIVIDUAL |
| Status | ACTIVE - CURRENT |
| Active | 1 |
| Issue Date | 1976-06-17 |
| Effective Date | 2020-03-01 |
| Expiration Date | 2021-02-28 |
| Refresh Date | 2019-12-29 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 153424 | CSP.0005626 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 1999-03-01 | 2019-03-01 - 2021-02-28 | ACTIVE |
| Street Address | 96 GREAT HILL DR |
| City | BETHEL |
| State | CT |
| Zip Code | 06801-1880 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Cortney B. Davis Aprn | 96 Great Hill Dr, Bethel, CT 06801-1880 | Registered Nurse | 2019-10-01 ~ 2020-09-30 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Constance M Booth | 64 Great Hill Dr, Bethel, CT 06801-1880 | Real Estate Salesperson | 2020-06-01 ~ 2021-05-31 |
| Mary Ann Manabat | 38 Great Hill Dr, Bethel, CT 06801-1880 | Pharmacy Technician | 2020-04-01 ~ 2021-03-31 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| John Anthony Dulko | 6 Winthrop Road, Bethel, CT 06801 | Notary Public Appointment | 2020-06-26 ~ 2025-06-30 |
| Antonietta Sproviero-metaxas | 36 Quaker Ridge Road, Bethel, CT 06801 | Hairdresser/cosmetician | 2020-07-01 ~ 2022-06-30 |
| Mark K Roos | 6 Crestview Road, Bethel, CT 06801 | Licensed Clinical Social Worker | 2020-07-01 ~ 2021-06-30 |
| Susan Nguyen | 14b Cawley Ave., Bethel, CT 06801 | Esthetician | ~ |
| Blue Jay Orchards | 125 Plumtrees Rd, Bethel, CT 06801 | Operator of Weighing & Measuring Devices | 2020-08-01 ~ 2021-07-31 |
| Varano Bakery | 198 Greenwood Ave, Bethel, CT 06801 | Operator of Weighing & Measuring Devices | 2020-08-01 ~ 2021-07-31 |
| Nina M Kilcourse | 3 Bayberry Hill Rd, Bethel, CT 06801 | Hairdresser/cosmetician | 2020-09-01 ~ 2022-08-31 |
| Ralph Ramsdell · Big Y | 83 Stony Hill Road, Bethel, CT 06801 | Grocery Beer | 2020-04-18 ~ 2021-04-17 |
| Marilu F Jeton | 36 Weed Rd, Bethel, CT 06801 | Combination Nail Technician, Esthetician Or Eyelash Technici | ~ |
| Petagay V Hewitt | 44 Greenwood Avenue, Bethel, CT 06801 | Real Estate Salesperson | ~ |
| Find all Licenses in zip 06801 | |||
| City | BETHEL |
| Zip Code | 06801 |
| License Type | Physician/Surgeon |
| License Type + County | Physician/Surgeon + BETHEL |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Gordon Kuster Md | P.o. Box 103, Stephentown, NY 12168 | Physician/surgeon | 2020-01-01 ~ 2020-12-31 |
| Gordon K Sze | 123 York Street, New Haven, CT 06511 | Physician/surgeon | 2020-04-01 ~ 2021-03-31 |
| Benjamin D Gordon Md | 14 Hillsea Rd, Yarmouth, MD 02675-1111 | Physician/surgeon | 2003-01-16 ~ 2004-03-31 |
| Barry Gordon Do | 455 Lewis Ave, Meriden, CT 06451 | Physician/surgeon | 2020-07-01 ~ 2021-06-30 |
| Gordon L Engler | La County Usc Med Ct, Los Angeles, CA 90033 | Physician/surgeon | 1995-06-15 ~ 1996-08-31 |
| Gordon F Buchanan | 345 Old Whitfield St, Guilford, CT 06437 | Physician/surgeon | 2014-07-01 ~ 2015-06-30 |
| Ram Y Gordon | 20 Commerce Park, Milford, CT 06460-3511 | Physician/surgeon | 2020-06-01 ~ 2021-05-31 |
| Gordon C Streeter Md | 51 Island Ave, Madison, CT 06443 | Physician/surgeon | 2020-04-01 ~ 2021-03-31 |
| Gordon S Raskin | P.o.box 8372, Berkeley, CA 94107 | Physician/surgeon | 2003-02-27 ~ 2004-02-29 |
| Gordon D Jensen | 789 Howard Ave, New Haven, CT 06519-1304 | Physician/surgeon | ~ 1954-01-31 |
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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).