JACK C CLARK SR. (Credential# 557830) is licensed (Physician/surgeon) with Connecticut Department of Consumer Protection. The license effective date is January 17, 2007. The license expiration date date is February 29, 2008. The license status is INACTIVE.
JACK C CLARK SR. is licensed with the Department of Consumer Protection of Connecticut. The credential number is #1.040247. The credential type is physician/surgeon. The effective date is January 17, 2007. The expiration date is February 29, 2008. The business address is 554 Halstead Drive, Crossville, TN 38555. The current status is inactive.
| Licensee Name | JACK C CLARK SR. |
| Credential ID | 557830 |
| Credential Number | 1.040247 |
| Credential Type | Physician/Surgeon |
| Business Address |
554 Halstead Drive Crossville TN 38555 |
| Business Type | INDIVIDUAL |
| Status | INACTIVE - LAPSED DUE TO NON-RENEWAL |
| Issue Date | 2002-03-18 |
| Effective Date | 2007-01-17 |
| Expiration Date | 2008-02-29 |
| Refresh Date | 2009-07-08 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 304636 | CSP.0031944 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 2007-03-01 - 2008-02-29 | INACTIVE |
| Street Address | 554 Halstead Drive |
| City | Crossville |
| State | TN |
| Zip Code | 38555 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Flowers Bakery of Crossville LLC | 1067 North Main St, Crossville, TN 38555 | Bakery | 2020-07-01 ~ 2021-06-30 |
| Michele R Isaacson | 1871 Hwy 70 E, Crossville, TN 38555 | Registered Nurse | 2020-07-01 ~ 2021-06-30 |
| Renee H Tinsley | 200 Dogwood Ave, Crossville, TN 38555 | Registered Nurse | 2008-04-28 ~ 2009-04-30 |
| Gayle B Winningham | 83 Jada Drive, Crossville, TN 38555 | Registered Nurse | 2000-06-15 ~ 2001-07-31 |
| Wags and Whiskers Inc | 121 Creek View Dr, Crossville, TN 38555-1314 | Animal Importer | 2014-01-01 ~ 2014-12-31 |
| Focus On Cumberland County Animal Shelter Inc | 707 S Main St, Crossville, TN 38555-5011 | Animal Importer | 2019-04-05 ~ 2020-12-31 |
| Focus On Cumberland County Animal Shelter · Foccas | 707 S Main St, Crossville, TN 38555-5011 | Public Charity | 2019-04-16 ~ 2019-11-30 |
| United States of America Chess Federation | 137 Obrien Dr, Crossville, TN 38555-8725 | Public Charity | 2020-05-01 ~ 2021-04-30 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Ellen P Rosenfeldt | 1859 Clear Creek Road, Crossville, TN 38571 | Licensed Practical Nurse | 2020-04-01 ~ 2021-03-31 |
| Connie Diane Sampley | 445 Grace Hill Dr, Crossville, TN 38571-1626 | Registered Nurse | 2020-03-02 ~ 2021-03-31 |
| Sherylann E Pica | 104 Kenwood Dr, Crossville, TN 38558-2826 | Occupational Therapist Assistant | 2017-08-01 ~ 2019-07-31 |
| Joann Kay Combs | 539 W Creston Rd, Crossville, TN 38571-3626 | Registered Nurse | 2020-01-01 ~ 2020-12-31 |
| Dan J Pastore | 8929 Cherokee Trail, Crossville, TN 38572 | Heating, Piping & Cooling Unlimited Journeyperson | 2019-09-01 ~ 2020-08-31 |
| Barbara A Berghauser | 31 Byron Lane, Crossville, TN 38558 | Hairdresser/cosmetician | 2016-10-01 ~ 2018-09-30 |
| Melanie L Young | 381 W Creston Rd, Crossville, TN 38571-3610 | Respiratory Care Practitioner | 2017-04-01 ~ 2018-03-31 |
| Caren H Nelson | 22 Bent Oak Ln, Crossville, TN 38558-2887 | Dental Hygienist | 2017-02-01 ~ 2018-01-31 |
| Michael F Kelly Sr | 4317 Chestnut Hill Rd, Crossville, TN 38571 | Electrical Unlimited Journeyperson | 2015-10-01 ~ 2016-09-30 |
| Ronnie L Norrod Jr | 2250 Bear Creek Rd, Crossville, TN 38571-0849 | Heating, Piping & Cooling Limited Journeyperson | 2015-09-01 ~ 2016-08-31 |
| Find all Licenses in Crossville | |||
| City | Crossville |
| Zip Code | 38555 |
| License Type | Physician/Surgeon |
| License Type + County | Physician/Surgeon + Crossville |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Will Jack Build LLC · Douglas W Clark Jr. | 1756 Long Hill Rd, Guilford, CT 06437-1572 | Home Improvement Contractor | 2012-02-21 ~ 2012-11-30 |
| Jack Liu | 1345 Rxr Plz, Uniondale, NY 11556-1301 | Physician/surgeon | 2020-04-01 ~ 2021-03-31 |
| Jack A Miller | 384 West Rd, Alford, MA 01266 | Physician/surgeon | 2020-03-01 ~ 2021-02-28 |
| Jack Hajjar Md | 169 South Rd, Farmington, CT 06032 | Physician/surgeon | 2001-05-08 ~ 2002-06-30 |
| Jack W Snyder Md | 104 Hilary Cir, Fairfield, CT 06432 | Physician/surgeon | 2003-08-04 ~ 2004-07-31 |
| Jack L Baldasar | 220 Oxford Dr, Tenafly, NJ 07670-3118 | Physician/surgeon | 2015-09-01 ~ 2016-08-31 |
| Jack J Forest Md | 111 Harbor Rd, Westport, CT 06880 | Physician/surgeon | 2006-05-23 ~ 2007-04-30 |
| Jack F Perrone | 586 23rd Ave Sw, Rochester, MN 55902-0965 | Physician/surgeon | 2016-04-01 ~ 2017-03-31 |
| Jack M Dodick | 535 Park Ave, New York, NY 10021 | Physician/surgeon | 2018-04-26 ~ 2019-03-31 |
| Jack F Wilder | 363 Shore Rd, Greenwich, CT 06830 | Physician/surgeon | 1998-01-30 ~ 1999-01-31 |
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| 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).