JENNIFER KIM MD (Credential# 556412) is licensed (Physician/surgeon) with Connecticut Department of Consumer Protection. The license effective date is August 1, 2020. The license expiration date date is July 31, 2021. The license status is ACTIVE.
JENNIFER KIM MD is licensed with the Department of Consumer Protection of Connecticut. The credential number is #1.038824. The credential type is physician/surgeon. The effective date is August 1, 2020. The expiration date is July 31, 2021. The business address is 11995 Singletree Lane, Eden Prairie, MN 55344. The current status is active.
| Licensee Name | JENNIFER KIM MD |
| Credential ID | 556412 |
| Credential Number | 1.038824 |
| Credential Type | Physician/Surgeon |
| Business Address |
11995 Singletree Lane Eden Prairie MN 55344 |
| Business Type | INDIVIDUAL |
| Status | ACTIVE - CURRENT |
| Active | 1 |
| Issue Date | 2000-07-03 |
| Effective Date | 2020-08-01 |
| Expiration Date | 2021-07-31 |
| Refresh Date | 2020-06-06 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 936093 | CSP.0047794 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 2010-06-17 | 2019-03-01 - 2021-02-28 | ACTIVE |
| 308803 | CSP.0032132 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 2003-03-01 - 2004-02-28 | INACTIVE |
| Street Address | 11995 SINGLETREE LANE |
| City | EDEN PRAIRIE |
| State | MN |
| Zip Code | 55344 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Donald T Nicell | 11995 Singletree Lane, Eden Prairie, MN 55344 | Physician/surgeon | 2020-08-01 ~ 2021-07-31 |
| Alan J Kopp | 11995 Singletree Lane, Eden Prairie, MN 55344 | Physician/surgeon | 2020-08-01 ~ 2021-07-31 |
| Joseph Michael Rozell | 11995 Singletree Lane, Eden Prairie, MN 55344 | Physician/surgeon | 2020-07-01 ~ 2021-06-30 |
| Jeffrey Brian Cutler | 11995 Singletree Lane, Eden Prairie, MN 55344 | Physician/surgeon | 2020-06-01 ~ 2021-05-31 |
| Wendy Elaine Zimmer | 11995 Singletree Lane, Eden Prairie, MN 55344 | Physician/surgeon | 2020-06-01 ~ 2021-05-31 |
| Richard T. Kaplan | 11995 Singletree Lane, Eden Prairie, MN 55344 | Physician/surgeon | 2020-06-01 ~ 2021-05-31 |
| Kevin Charles Wright | 11995 Singletree Lane, Eden Prairie, MN 55344 | Physician/surgeon | 2020-05-01 ~ 2021-04-30 |
| Raymond Bozman | 11995 Singletree Lane, Eden Prairie, MN 55344 | Physician/surgeon | 2020-04-01 ~ 2021-03-31 |
| Christopher M. Garcia | 11995 Singletree Lane, Eden Prairie, MN 55344 | Physician/surgeon | 2020-04-01 ~ 2021-03-31 |
| Peter B Zelinka Md | 11995 Singletree Lane, Eden Prairie, MN 55344 | Physician/surgeon | 2020-03-01 ~ 2021-02-28 |
| Find all Licenses in the same address | |||
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Neuroone Medical Technologies Corp | 7599 Anagram Dr, Eden Prairie, MN 55344 | Securities - Exemptions | 2020-05-15 ~ |
| Robert Edward Stone | 11995 Singletree Lane, Ste 500, Eden Prairie, MN 55344 | Physician/surgeon | 2020-07-01 ~ 2021-06-30 |
| Daniel James Tangert | 6400 Fallbrook Rd., Eden Prairie, MN 55344 | Registered Nurse | 2020-05-01 ~ 2021-04-30 |
| Dmitry Bolkhovets | 11995 Singletree Ln, Eden Prairie, MN 55344 | Physician/surgeon | 2020-05-01 ~ 2021-04-30 |
| Zinpro | 104000 Vikings Drive, Suite 240, Eden Prairie, MN 55344 | Commercial Feed | 2020-03-05 ~ 2020-12-31 |
| Michael Wallace Sentome | 11995 Singletree Lane, Suite 500, Eden Prairie, MN 55344 | Physician/surgeon | 2020-05-01 ~ 2021-04-30 |
| Stephanie Denise Johnson | 8423 Cortland Rd, Eden Prairie, MN 55344 | Registered Nurse | 2020-06-01 ~ 2021-05-31 |
| Ashley Nicole Ingram | 11000 Optum Circle, Eden Prairie, MN 55344 | Registered Nurse | 2020-01-16 ~ 2020-08-31 |
| Colleen M Steven | 13900 Chestnut Drive # 208, Eden Prarie, MN 55344 | Registered Nurse | 2019-12-01 ~ 2020-11-30 |
| Rebecca Dipofi Rogers | 13625 Technology Dr, Eden Prairie, MN 55344 | Registered Nurse | 2019-09-01 ~ 2020-08-31 |
| Find all Licenses in zip 55344 | |||
| City | EDEN PRAIRIE |
| Zip Code | 55344 |
| License Type | Physician/Surgeon |
| License Type + County | Physician/Surgeon + EDEN PRAIRIE |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Jennifer L Yeh Md | 4 Smith Dr, Savannah, GA 31406-6441 | Physician/surgeon | 2012-12-01 ~ 2013-11-30 |
| Jennifer H. Kuo | 161 Fort Washington Ave Fl 8, New York, NY 10032-3729 | Physician/surgeon | ~ |
| Jennifer Lax Md | 23 Old Stone Bridge Rd, Cos Cob, CT 06807-1511 | Physician/surgeon | 2003-05-16 ~ 2004-02-29 |
| Jennifer L Bau | 1 Guthrie Sq, Sayre, PA 18840-1625 | Physician/surgeon | 2017-03-01 ~ 2018-02-28 |
| Jennifer R Lee Md | 85 Viscount Dr#8c, Milford, CT 06460 | Physician/surgeon | 2018-06-01 ~ 2019-05-31 |
| Jennifer F Cross | 19 W Brookside Dr, Larchmont, NY 10538 | Physician/surgeon | 1992-03-24 ~ 1993-02-28 |
| Jennifer Mcniff | 35 Marshall Ave, Guilford, CT 06437 | Physician/surgeon | 2020-03-01 ~ 2021-02-28 |
| Jennifer J Wheler | 33 Hubinger St, New Haven, CT 06511-4034 | Physician/surgeon | 2005-05-31 ~ 2006-05-31 |
| Jennifer Mcquiston | 23134 Newcut Rd, Clarksburg, MD 20871-9377 | Physician/surgeon | ~ |
| Jennifer Rebecca Hill | 51-53 Kenosia Ave, Danbury, CT 06810 | Physician/surgeon | ~ |
Please comment or provide details below to improve the information on JENNIFER KIM MD.
| 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).