DAVID M CHADBOURNE (Credential# 547439) is licensed (Physician/surgeon) with Connecticut Department of Consumer Protection. The license effective date is December 1, 2013. The license expiration date date is November 30, 2014. The license status is INACTIVE.
DAVID M CHADBOURNE is licensed with the Department of Consumer Protection of Connecticut. The credential number is #1.028880. The credential type is physician/surgeon. The effective date is December 1, 2013. The expiration date is November 30, 2014. The business address is 100 Wason Ave Ste 240, Springfield, MA 01107-1119. The current status is inactive.
| Licensee Name | DAVID M CHADBOURNE |
| Credential ID | 547439 |
| Credential Number | 1.028880 |
| Credential Type | Physician/Surgeon |
| Business Address |
100 Wason Ave Ste 240 Springfield MA 01107-1119 |
| Business Type | INDIVIDUAL |
| Status | INACTIVE - LAPSED DUE TO NON-RENEWAL |
| Issue Date | 1988-03-11 |
| Effective Date | 2013-12-01 |
| Expiration Date | 2014-11-30 |
| Refresh Date | 2015-03-05 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 156439 | CSP.0016483 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 1994-08-26 - 1996-08-01 | INACTIVE |
| Street Address | 100 WASON AVE STE 240 |
| City | SPRINGFIELD |
| State | MA |
| Zip Code | 01107-1119 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Barbara A Greco Md | 100 Wason Ave Ste 200, Springfield, MA 01107-1119 | Physician/surgeon | 2020-06-01 ~ 2021-05-31 |
| Benjamin J Freda Do | 100 Wason Ave Ste 200, Springfield, MA 01107-1119 | Physician/surgeon | 2014-09-01 ~ 2015-08-31 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Lauren Elizabeth Marshall | 945 Armory St, Springfield, MA 01107 | Physician Assistant | 2020-04-01 ~ 2021-03-31 |
| Jennifer L Fish | 367 Union Street, Springfield, MA 01107 | Hairdresser/cosmetician | ~ |
| Joseph Pagan | 59 Rowland Street, Springfield, MA 01107 | Medication Administration Certification | 2020-04-20 ~ 2022-04-19 |
| Daniel Laguerre | 382 Springfield St, Springfield, MA 01107 | Crane Operator | ~ |
| Kamal Kant Kalia | 2 Medical Center Drive, Springfield, MA 01107 | Physician/surgeon | 2020-03-01 ~ 2021-02-28 |
| Bushee Enterprises LLC | Po Box 1196, Southwick, MA 01107 | Home Improvement Contractor | 2015-12-01 ~ 2016-11-30 |
| B Lopez | 165 Prospect Street, Springfield, MA 01107 | Notary Public Appointment | 2011-10-01 ~ 2016-09-30 |
| Beth C Mcinerny | 260 Ware Road, Belchertown, MA 01107 | Registered Nurse | 2019-12-01 ~ 2020-11-30 |
| Jorge Enrique Rivera | 20 Narragansett Street, Springfield, MA 01107 | Professional Counselor | 2019-10-01 ~ 2020-09-30 |
| Rachael Hynds-decoteau | 22 Candice Cir, Springfield, MA 01107 | Controlled Substance Registration for Practitioner | 2019-09-19 ~ 2021-02-28 |
| Find all Licenses in zip 01107 | |||
| City | SPRINGFIELD |
| Zip Code | 01107 |
| License Type | Physician/Surgeon |
| License Type + County | Physician/Surgeon + SPRINGFIELD |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| David C Kim | 1345 Rxr Plz, Uniondale, NY 11556-1301 | Physician/surgeon | 2019-04-01 ~ 2020-03-31 |
| David L Maxham | Box 517, Woodstock, VT 05091 | Physician/surgeon | 1994-03-07 ~ 1995-02-28 |
| David D Giardina | 10 Little Fox La, Westport, CT 06880 | Physician/surgeon | 2004-07-06 ~ 2005-07-31 |
| David I Soybel | Fmb 109, New Haven, CT 06511 | Physician/surgeon | 1992-10-23 ~ 1993-11-30 |
| David G. Srour Md | Rockville, MD 20850 | Physician/surgeon | 2012-07-01 ~ 2013-06-30 |
| David Zhou | 125 Paterson St, Meb 233, New Brunswick, NJ 08903 | Physician/surgeon | ~ |
| David Khaski | 372 Avenue U Ste 1b, Brooklyn, NY 11223-4052 | Physician/surgeon | ~ |
| David S Wilcox | P.o. Box 384, Osterville, MA 02655 | Physician/surgeon | 1996-03-14 ~ 1997-05-31 |
| David H Barad | 21 E 69th St, New York, NY 10021-4917 | Physician/surgeon | ~ |
| David J Rea | 5699 N Centerpark Way Apt 502, Glendale, WI 53217-4571 | Physician/surgeon | ~ |
Please comment or provide details below to improve the information on DAVID M CHADBOURNE.
| 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).