JIN SOO PARK (Credential# 545214) is licensed (Physician/surgeon) with Connecticut Department of Consumer Protection. The license effective date is November 19, 1997. The license expiration date date is November 30, 1998. The license status is INACTIVE.
JIN SOO PARK is licensed with the Department of Consumer Protection of Connecticut. The credential number is #1.024848. The credential type is physician/surgeon. The effective date is November 19, 1997. The expiration date is November 30, 1998. The business address is 73 Baldwin Hill Rd, Litchfield, CT 06759. The current status is inactive.
Licensee Name | JIN SOO PARK |
Credential ID | 545214 |
Credential Number | 1.024848 |
Credential Type | Physician/Surgeon |
Business Address |
73 Baldwin Hill Rd Litchfield CT 06759 |
Business Type | INDIVIDUAL |
Status | INACTIVE - LAPSED DUE TO NON-RENEWAL |
Issue Date | 1983-07-14 |
Effective Date | 1997-11-19 |
Expiration Date | 1998-11-30 |
Refresh Date | 2009-07-08 |
ID | Credential Code | Credential Type | Issue | Term | Status |
---|---|---|---|---|---|
143347 | CSP.0011622 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 1997-03-01 - 1998-02-28 | INACTIVE |
Street Address | 73 BALDWIN HILL RD |
City | LITCHFIELD |
State | CT |
Zip Code | 06759 |
Licensee Name | Office Address | Credential | Effective / Expiration |
---|---|---|---|
Marisa Concilio | 138 South Lake St, Litchfield, CT 06759 | Occupational Therapist Temporary Permit | ~ |
True Value of Litchfield | 348 Bantam Rd, Litchfield, CT 06759 | Operator of Weighing & Measuring Devices | 2020-08-01 ~ 2021-07-31 |
Jeanne M Sandrib | 22 Minerva Lane, Litchfield, CT 06759 | Registered Nurse | 2020-07-01 ~ 2021-06-30 |
Albreada Refuse & Sweeping LLC | 14 Iffland Pond Rd, Litchfield, CT 06759 | Operator of Weighing & Measuring Devices | 2020-08-01 ~ 2021-07-31 |
Theresa M. Spalletta | 470 Pumping Station Rd., Litchfield, CT 06759 | Distribution System Operator In Training | 2020-04-01 ~ 2023-03-31 |
Lisa Ann Partrick | 190 West Street, Litchfield, CT 06759 | Notary Public Appointment | 2020-07-01 ~ 2025-06-30 |
Debra A Majeske · Cooper | 230 Blue Swamp Road, Litchfield, CT 06759 | Licensed Clinical Social Worker | 2020-08-01 ~ 2021-07-31 |
Tilden Seafood LLC | 174 West St, Litchfield, CT 06759 | Operator of Weighing & Measuring Devices | 2020-08-01 ~ 2021-07-31 |
Cassandra Leigh Ganio | 93 Headquarters Road, Litchfield, CT 06759 | Master's Level Social Worker | 2020-06-01 ~ 2021-05-31 |
Denise Konnik | 344 Milton Rd, Litchfield, CT 06759 | Registered Nurse | 2020-09-01 ~ 2021-08-31 |
Find all Licenses in zip 06759 |
City | LITCHFIELD |
Zip Code | 06759 |
License Type | Physician/Surgeon |
License Type + County | Physician/Surgeon + LITCHFIELD |
Licensee Name | Office Address | Credential | Effective / Expiration |
---|---|---|---|
Alan H Spiro | 350 N Deere Park Dr, Highland Park, IL 60035 | Physician/surgeon | 1992-07-23 ~ 1993-07-31 |
Hareem Park | 10 Park Row West, Providence, RI 02903 | Physician/surgeon | 2020-09-01 ~ 2021-08-31 |
Mark Andrew Ciagne | 3850 Park Nicollet Blvd, St. Louis Park, MN 55416 | Physician/surgeon | 2019-06-12 ~ 2020-03-31 |
Steven J Balsamo | 523 Clifton Park, Clifton Park, NY 12065 | Physician/surgeon | 2013-01-01 ~ 2013-12-31 |
Mikhail Amoashiy | 256 Floral Park Way, Floral Park, NY 11001 | Physician/surgeon | 1997-10-27 ~ 1998-12-31 |
Anh T Dao | 24 Park Pl Apt 9h, Hartford, CT 06106-5022 | Physician/surgeon | 2015-11-01 ~ 2016-10-31 |
In Soon Kim | 71-14 Little Nec Pk, Floral Park, NY 11004 | Physician/surgeon | 2008-05-27 ~ 2009-02-28 |
Sam S Ahn Md | 111 Park St Apt 11a, New Haven, CT 06511 | Physician/surgeon | 2007-01-26 ~ 2008-02-29 |
Sumera Bukhari | 50 Park Row, Providence, RI 02903 | Physician/surgeon | ~ |
Christine J Lim | 111 Park St #4g, New Haven, CT 06511 | Physician/surgeon | 2005-12-23 ~ 2007-02-28 |
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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).