SAMUEL S FAGER (Credential# 547255) is licensed (Physician/surgeon) with Connecticut Department of Consumer Protection. The license effective date is June 1, 2019. The license expiration date date is May 31, 2020. The license status is ACTIVE.
SAMUEL S FAGER is licensed with the Department of Consumer Protection of Connecticut. The credential number is #1.028579. The credential type is physician/surgeon. The effective date is June 1, 2019. The expiration date is May 31, 2020. The business address is 1415 Old Gulph Road, Villanova, PA 19085. The current status is active.
| Licensee Name | SAMUEL S FAGER |
| Credential ID | 547255 |
| Credential Number | 1.028579 |
| Credential Type | Physician/Surgeon |
| Business Address |
1415 Old Gulph Road Villanova PA 19085 |
| Business Type | INDIVIDUAL |
| Status | ACTIVE - CURRENT |
| Active | 1 |
| Issue Date | 1987-10-09 |
| Effective Date | 2019-06-01 |
| Expiration Date | 2020-05-31 |
| Refresh Date | 2019-06-30 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 157307 | CSP.0015786 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 1998-03-01 - 1999-02-28 | INACTIVE |
| Street Address | 1415 OLD GULPH ROAD |
| City | VILLANOVA |
| State | PA |
| Zip Code | 19085 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Laura C Staines | 447 Inveraray, Villanova, PA 19085 | Architect | 2020-08-01 ~ 2021-07-31 |
| Chad M Kimerer | 216 S. Spring Mill Rd., Villanova, PA 19085 | Real Estate Broker | 2020-04-01 ~ 2021-03-31 |
| Mathew Moger | 501 Conestoga Road, Villanova, PA 19085 | Architect | 2019-03-13 ~ 2019-07-31 |
| Devereux Foundation | 444 Devereux Drive, Villanova, PA 19085 | Public Charity-exempt From Financial Requirements | ~ |
| Frank G Rennis | 540 Oriole La, Villanova, PA 19085 | Professional Engineer | 1990-12-12 ~ 1992-01-31 |
| Charles A Mauriello | P.o Box 570, Villanova, PA 19085 | Physician/surgeon | 2010-08-01 ~ 2011-07-31 |
| Dinesh H Jagasia | 4 Chalous Lane, Villanova, PA 19085 | Physician/surgeon | 2009-11-01 ~ 2010-10-31 |
| Judith G Repp | 768 Mt Moro Rd, Villanova, PA 19085 | Architect | 2003-09-26 ~ 2004-07-31 |
| Thomas Edwin Hall | 839 Mt Moro Rd, Villanova, PA 19085 | Architect | 2001-08-01 ~ 2002-07-31 |
| Anuja Dokras-jagasia | 4 Chalovs Lane, Villanova, PA 19085 | Physician/surgeon | 2008-10-17 ~ 2009-11-30 |
| Find all Licenses in zip 19085 | |||
| City | VILLANOVA |
| Zip Code | 19085 |
| License Type | Physician/Surgeon |
| License Type + County | Physician/Surgeon + VILLANOVA |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Samuel Song | 1150 North Indian Canyon Drive, Palm Springs, CA 92262 | Physician/surgeon | 2020-06-01 ~ 2021-05-31 |
| Samuel A Adesoba | P.o. Box 876, New York, NY 10037 | Physician/surgeon | ~ 1997-10-31 |
| Samuel S Fam | Po Box 31294, Clarksville, TN 37040-0022 | Physician/surgeon | 2020-06-01 ~ 2021-05-31 |
| Samuel Bergman | Po Box 516, Durham, CT 06422-0516 | Physician/surgeon | 1982-06-22 ~ 1984-04-30 |
| Samuel J Beran | Suite 412, Harrison, NY 10528 | Physician/surgeon | 2019-07-01 ~ 2020-06-30 |
| Samuel J Potolicchio Jr | 2601 N 3rd St, Harrisburg, PA 17110-2046 | Physician/surgeon | 1980-03-19 ~ 1981-03-31 |
| Samuel Jacobs | 21 E Lake Cir, Medford, NJ 08055-3440 | Physician/surgeon | 1988-05-13 ~ 1990-12-31 |
| Samuel D Kao | C/o H Kirk Watson, Hartford, CT 06106 | Physician/surgeon | 1994-02-23 ~ 1995-04-30 |
| Samuel D Critides | 9578 Bay Point Dr, Norfolk, VA 23518-2050 | Physician/surgeon | ~ |
| Samuel T Ostrower Md | 415 Derby Ave, Orange, CT 06477 | Physician/surgeon | 2011-02-01 ~ 2012-01-31 |
Please comment or provide details below to improve the information on SAMUEL S FAGER.
| 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).