KATHLEEN A WALLACE (Credential# 554151) is licensed (Physician/surgeon) with Connecticut Department of Consumer Protection. The license effective date is June 1, 2018. The license expiration date date is May 31, 2019. The license status is INACTIVE.
KATHLEEN A WALLACE is licensed with the Department of Consumer Protection of Connecticut. The credential number is #1.036560. The credential type is physician/surgeon. The effective date is June 1, 2018. The expiration date is May 31, 2019. The business address is 8 Springbrook Lane, Simsbury, CT 06070. The current status is inactive.
| Licensee Name | KATHLEEN A WALLACE |
| Credential ID | 554151 |
| Credential Number | 1.036560 |
| Credential Type | Physician/Surgeon |
| Business Address |
8 Springbrook Lane Simsbury CT 06070 |
| Business Type | INDIVIDUAL |
| Status | INACTIVE - LAPSED DUE TO NON-RENEWAL |
| Issue Date | 1997-12-26 |
| Effective Date | 2018-06-01 |
| Expiration Date | 2019-05-31 |
| Refresh Date | 2019-09-03 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 193399 | CSP.0026790 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 2000-02-29 - 2001-02-28 | INACTIVE |
| Street Address | 8 Springbrook Lane |
| City | Simsbury |
| State | CT |
| Zip Code | 06070 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Henry Withers | 571 Hopmeadow St, Simsbury, CT 06070 | Landscape Architect | 2020-08-01 ~ 2021-07-31 |
| Nancy W Flanagan | 9 Carver Circle, Simsbury, CT 06070 | Real Estate Salesperson | 2020-06-23 ~ 2021-05-31 |
| Catharina A Bates | 12 East View Dr., Simsbury, CT 06070 | Real Estate Salesperson | 2020-06-25 ~ 2021-05-31 |
| Faith E Preato | 25 Squadron Line Rd, Simsbury, CT 06070 | Registered Nurse | 2020-07-01 ~ 2021-06-30 |
| Diane Bragoni | 542 Hopmeadow Street, #128, Simsbury, CT 06070 | Architect | 2020-08-01 ~ 2021-07-31 |
| Virginia S Durst · Banks | 20 Woodcliff Drive, Simsbury, CT 06070 | Registered Nurse | 2020-05-01 ~ 2021-04-30 |
| Caitlin M Cornier | 18 Saxton Brook Drive, Simsbury, CT 06070 | Registered Nurse | 2020-07-01 ~ 2021-06-30 |
| Nancy L Alleva · Maule | 1079 Hopmeadow St, Simsbury, CT 06070 | Respiratory Care Practitioner | 2020-09-01 ~ 2021-08-31 |
| Stephen R Birghenti · Simsbury Inn | 397 Hopmeadow St, Simsbury, CT 06070 | Hotel Liquor (50000 Or More Population) | 2019-08-14 ~ 2020-12-13 |
| Deborah L Poniatowski · Blase | 35 Munnisunk Dr, Simsbury, CT 06070 | Registered Nurse | 2020-08-01 ~ 2021-07-31 |
| Find all Licenses in zip 06070 | |||
| City | Simsbury |
| Zip Code | 06070 |
| License Type | Physician/Surgeon |
| License Type + County | Physician/Surgeon + Simsbury |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Kathleen Wallace | 35 Nod Brook Rd, Wallingford, CT 06492-4314 | Certified Public Accountant Firm Permit | 2013-01-01 ~ 2013-12-31 |
| Ellen C Wallace | 25 Stearns Rd, Watertown, MA 02172 | Physician/surgeon | 1994-11-02 ~ 1995-12-31 |
| Max L Wallace Jr | 383 Rockwood Drive, Southington, CT 06489 | Physician/surgeon | 2017-09-01 ~ 2018-08-31 |
| Keri A Wallace Md | Ct Pediatrics At Chc, Hartford, CT 06106 | Physician/surgeon | 2020-06-01 ~ 2021-05-31 |
| Michael Lloyd Wallace | 875 Greentree Rd, Pittsburgh, PA 15220-3508 | Physician/surgeon | ~ |
| Christopher A Wallace | 6 Charlotte Ct, Avon, CT 06001-2257 | Physician/surgeon | 2020-06-01 ~ 2021-05-31 |
| Edward P Wallace Md | 285 Broad St, Meriden, CT 06450 | Physician/surgeon | 1999-02-11 ~ 2000-02-29 |
| John R Iacovino Md | 149 Legacy Woods Dr, Wallace, NC 28466 | Physician/surgeon | 2004-02-26 ~ 2005-02-28 |
| Daniel Wallace Dahl | 40 Prospect Ave, Norwalk, CT 06850 | Physician/surgeon | 2018-01-01 ~ 2018-12-31 |
| Wallace Duncan | 465 Buckland Hills, Manchester, CT 06050 | Physician/surgeon | ~ 1996-07-31 |
Please comment or provide details below to improve the information on KATHLEEN A WALLACE.
| 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).