RICHARD SIAHAAN (Credential# 544954) is licensed (Physician/surgeon) with Connecticut Department of Consumer Protection. The license effective date is July 1, 2020. The license expiration date date is June 30, 2021. The license status is ACTIVE.
RICHARD SIAHAAN is licensed with the Department of Consumer Protection of Connecticut. The credential number is #1.024303. The credential type is physician/surgeon. The effective date is July 1, 2020. The expiration date is June 30, 2021. The business address is 79 Timothy Terr, Windsor, CT 06095. The current status is active.
| Licensee Name | RICHARD SIAHAAN |
| Credential ID | 544954 |
| Credential Number | 1.024303 |
| Credential Type | Physician/Surgeon |
| Business Address |
79 Timothy Terr Windsor CT 06095 |
| Business Type | INDIVIDUAL |
| Status | ACTIVE - CURRENT |
| Active | 1 |
| Issue Date | 1983-02-04 |
| Effective Date | 2020-07-01 |
| Expiration Date | 2021-06-30 |
| Refresh Date | 2020-06-24 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 147623 | CSP.0012174 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 1999-03-01 | 2019-03-01 - 2021-02-28 | ACTIVE |
| 147626 | CSP.0012176 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 1996-03-01 - 1997-02-28 | INACTIVE |
| Street Address | 79 TIMOTHY TERR |
| City | WINDSOR |
| State | CT |
| Zip Code | 06095 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Cherene M Scott | 123 Clover St, Windsor, CT 06095 | Radiographer | 2020-07-01 ~ 2021-06-30 |
| Marianne Lauri | 9 Mohawk Circle, Windsor, CT 06095 | Registered Nurse | 2020-09-01 ~ 2021-08-31 |
| Elaine R Birthwright Rowe | 71 Ford Road, Windsor, CT 06095 | Real Estate Salesperson | ~ |
| Annmarie Blair-atkinson | 19 Hope Circle, Windsor, CT 06095 | Medication Administration Certification | 2020-05-23 ~ 2022-05-22 |
| Cristina Valente | 39 Lochview Dr, Windsor, CT 06095 | Master's Level Social Worker | 2020-07-01 ~ 2021-06-30 |
| Bridget C Tran | 500 Huckleberry Rd, Windsor, CT 06095 | Public Weigher | 2020-07-01 ~ 2021-06-30 |
| Kelli Price | 15 Berrios Hill Road, Windsor, CT 06095 | Professional Counselor | 2020-09-01 ~ 2021-08-31 |
| Yalanda Squirewell | 217 Willowcrest Drive, Windsor, CT 06095 | Real Estate Salesperson | ~ |
| Omason O Modeste | 30 Lepage Rd, Windsor, CT 06095 | Emergency Medical Technician | 2017-04-06 ~ 2020-06-30 |
| Mark E Allen | 372 Broad St, Windsor, CT 06095 | Architect | 2020-08-01 ~ 2021-07-31 |
| Find all Licenses in zip 06095 | |||
| City | WINDSOR |
| Zip Code | 06095 |
| License Type | Physician/Surgeon |
| License Type + County | Physician/Surgeon + WINDSOR |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Richard Pilot · Paul Richard Pilot | 5 Dock Watch Hollow Road, Warren, NJ 07059 | Physician/surgeon | 2019-11-01 ~ 2020-10-31 |
| Richard S Underkofler | CT | Physician/surgeon | 1983-07-01 ~ 1987-11-30 |
| Richard P. Goldmann | 68 S Service Rd Ste 350, Melville, NY 11747-2358 | Physician/surgeon | ~ |
| Richard W Long | 316 W 23 Rd., Erie, PA 16502 | Physician/surgeon | 2000-09-05 ~ 2001-09-30 |
| Benjamin Richard Jacobs | CT | Physician/surgeon | ~ 1992-03-31 |
| Richard S Childs Jr | Box 660, Norfolk, CT 06058 | Physician/surgeon | 2020-03-01 ~ 2021-02-28 |
| Richard Elizee | 95 Worth St, New York, NY 10013 | Physician/surgeon | ~ |
| Richard J Given | 400 E 52nd St Apt 4c, New York, NY 10022-6415 | Physician/surgeon | 2019-08-01 ~ 2020-07-31 |
| Richard Zhu | 597 Westport Ave., Norwalk, CT 06851 | Physician/surgeon | 2019-10-01 ~ 2020-09-30 |
| Richard Lee | 163 Third Avenue, New York, NY 10003 | Physician/surgeon | 1997-05-08 ~ 1998-05-31 |
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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).