WILLIAM W CLARK DO (Credential# 557257) is licensed (Physician/surgeon) with Connecticut Department of Consumer Protection. The license effective date is May 1, 2012. The license expiration date date is April 30, 2013. The license status is INACTIVE.
WILLIAM W CLARK DO is licensed with the Department of Consumer Protection of Connecticut. The credential number is #1.039673-DO. The credential type is physician/surgeon. The effective date is May 1, 2012. The expiration date is April 30, 2013. The business address is 17 Birch View Drive, Ellington, CT 06029. The current status is inactive.
| Licensee Name | WILLIAM W CLARK DO |
| Credential ID | 557257 |
| Credential Number | 1.039673-DO |
| Credential Type | Physician/Surgeon |
| Credential SubCategory | DO |
| Business Address |
17 Birch View Drive Ellington CT 06029 |
| Business Type | INDIVIDUAL |
| Status | INACTIVE - LAPSED DUE TO NON-RENEWAL |
| Issue Date | 2001-06-29 |
| Effective Date | 2012-05-01 |
| Expiration Date | 2013-04-30 |
| Refresh Date | 2013-08-05 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 365254 | CSP.0034777 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 2004-04-19 | 2011-03-17 - 2013-02-28 | INACTIVE |
| 448778 | HIC.0612577 | HOME IMPROVEMENT CONTRACTOR | 2006-08-25 | 2006-12-01 - 2007-11-30 | INACTIVE |
| 281409 | CSP.0031151 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 2004-02-29 - 2005-02-28 | INACTIVE |
| Street Address | 17 BIRCH VIEW DRIVE |
| City | ELLINGTON |
| State | CT |
| Zip Code | 06029 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Lisa M Houlihan | 42 Crane Road, Ellington, CT 06029 | Notary Public Appointment | 2020-06-26 ~ 2025-06-30 |
| Christine E Powers | 94 Abbott Road, Ellington, CT 06029 | Licensed Practical Nurse | 2020-08-01 ~ 2021-07-31 |
| Kathryn R Walker | 3 Maplewood Dr, Ellington, CT 06029 | Registered Nurse | 2020-09-01 ~ 2021-08-31 |
| Megan Elizabeth Knowling | 40 Ellridge Pl, Ellington, CT 06029 | Emergency Medical Technician | ~ |
| Elizabeth J Rhoads | 18 Crystal Ridge Dr., Ellington, CT 06029 | Registered Nurse | 2020-07-01 ~ 2021-06-30 |
| Nancy S Nicolescu | 21 Lake Street, Ellington, CT 06029 | Notary Public Appointment | 2020-10-01 ~ 2025-09-30 |
| Emily Albertson | 155 Windermere Ave #3005, Ellington, CT 06029 | Registered Nurse | ~ |
| Meghan Laughlan | 3 Crystal Ball Ct, Ellington, CT 06029 | Registered Nurse | 2020-07-01 ~ 2021-06-30 |
| Carly A Havener | 187 Mountain Street, Ellington, CT 06029 | Registered Nurse | 2020-09-01 ~ 2021-08-31 |
| Carol G Aborn | 21 Upper Butcher Rd., Ellington, CT 06029 | Dental Hygienist | 2020-09-01 ~ 2021-08-31 |
| Find all Licenses in zip 06029 | |||
| City | ELLINGTON |
| Zip Code | 06029 |
| License Type | Physician/Surgeon |
| License Type + County | Physician/Surgeon + ELLINGTON |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| William E Clark II | 175 Shadow Rock Dr, Sedona, AZ 86336-3450 | Physician/surgeon | 1997-07-09 ~ 1998-06-30 |
| William Avery Pa | 120 Clark St, Milford, CT 06460 | Physician Assistant | 2007-07-19 ~ 2008-08-31 |
| Matthew S Clark | Po Box 129, Montrose, NY 10548-0129 | Physician/surgeon | 2019-12-01 ~ 2020-11-30 |
| R S Briggs Md | 138 Clark Rd, Litchfield, CT 06759 | Physician/surgeon | 2006-12-21 ~ 2007-12-31 |
| Ann O Massion Md | 157 Clark St, Worcester, MA 01606 | Physician/surgeon | 2002-04-16 ~ 2003-05-31 |
| Michael H Clark | P.o.box 1291, Goldsboro, NC 27533 | Physician/surgeon | 1999-08-19 ~ 2000-08-31 |
| Karen Clark | 444 W Baltimore Ave Apt 232, Media, PA 19063-3695 | Physician/surgeon | 2020-06-10 ~ 2021-06-30 |
| Denise Clark | 1 North Ln, Albany, NY 12211-1629 | Physician/surgeon | 2020-08-01 ~ 2021-07-31 |
| Shana S. Clark | 921 Route 11 South, Kirkwood, NY 13795 | Physician/surgeon | ~ |
| Leo P Clark | 3812 Windward Dr., Sylvania, OH 43560 | Physician/surgeon | 2020-06-01 ~ 2021-05-31 |
Please comment or provide details below to improve the information on WILLIAM W CLARK DO.
| 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).