JIN SOO PARK
Physician/surgeon


Address: 73 Baldwin Hill Rd, Litchfield, CT 06759

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.

Business Overview

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.

Basic Information

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

Other licenses

ID Credential Code Credential Type Issue Term Status
143347 CSP.0011622 CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER 1997-03-01 - 1998-02-28 INACTIVE

Office Location

Street Address 73 BALDWIN HILL RD
City LITCHFIELD
State CT
Zip Code 06759

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Competitor

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City LITCHFIELD
Zip Code 06759
License Type Physician/Surgeon
License Type + County Physician/Surgeon + LITCHFIELD

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Dataset Information

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).

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