EDMUND A KIM MD (Credential# 558916) is licensed (Physician/surgeon) with Connecticut Department of Consumer Protection. The license effective date is June 1, 2020. The license expiration date date is May 31, 2021. The license status is ACTIVE.
EDMUND A KIM MD is licensed with the Department of Consumer Protection of Connecticut. The credential number is #1.041333. The credential type is physician/surgeon. The effective date is June 1, 2020. The expiration date is May 31, 2021. The business address is Prohealth Physicians, Farmington, CT 06032. The current status is active.
| Licensee Name | EDMUND A KIM MD |
| Credential ID | 558916 |
| Credential Number | 1.041333 |
| Credential Type | Physician/Surgeon |
| Business Address |
Prohealth Physicians Farmington CT 06032 |
| Business Type | INDIVIDUAL |
| Status | ACTIVE - CURRENT |
| Active | 1 |
| Issue Date | 2003-04-09 |
| Effective Date | 2020-06-01 |
| Expiration Date | 2021-05-31 |
| Refresh Date | 2020-05-26 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 344347 | CSP.0033785 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 2002-07-14 | 2019-03-01 - 2021-02-28 | ACTIVE |
| 867681 | 70.950361 | Emergency Medical Technician | 1995-01-01 | - 1996-12-31 | INACTIVE |
| Street Address | ProHealth Physicians |
| City | Farmington |
| State | CT |
| Zip Code | 06032 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Jennifer Donahue | Prohealth Physicians, Farmington, CT 06032 | Physician/surgeon | 2020-09-01 ~ 2021-08-31 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Kyeongsuk Lee Lee | 11- A1 Lakeshore Dr, Farmington, CT 06032 | Nail Technician | ~ |
| Lynne M Ramer · Sobowicz | 13 Wentworth Park, Farmington, CT 06032 | Registered Nurse | 2020-08-01 ~ 2021-07-31 |
| Scott's Townline Mobil LLC | 435 Main St, Farmington, CT 06032 | Operator of Weighing & Measuring Devices | 2020-08-01 ~ 2021-07-31 |
| Glenna E Voytovich · Mietz | 47 Carriage Dr, Farmington, CT 06032 | Marital and Family Therapist | 2020-09-01 ~ 2021-08-31 |
| Munsons Chocolates | 463 Westfarms Mall, Farmington, CT 06032 | Operator of Weighing & Measuring Devices | 2020-08-01 ~ 2021-07-31 |
| Kimberly A. Caprio | Hartford Healthcare Medical Group, Farmington, CT 06032 | Physician/surgeon | 2020-07-01 ~ 2021-06-30 |
| Stephanie A. Fink | 22 Kent Lane, Farmington, CT 06032 | Registered Nurse | 2020-07-01 ~ 2021-06-30 |
| Farmington Donuts LLC · Dunkins Donuts | 348 Colt Hwy, Farmington, CT 06032 | Bakery | 2020-07-01 ~ 2021-06-30 |
| Angham Zakko | 2 Stratford Rd., Farmington, CT 06032 | Architect | 2020-08-01 ~ 2021-07-31 |
| Thomas N Taylor | 222 Main St # 264, Farmington, CT 06032 | Architect | 2020-08-01 ~ 2021-07-31 |
| Find all Licenses in zip 06032 | |||
| City | Farmington |
| Zip Code | 06032 |
| License Type | Physician/Surgeon |
| License Type + County | Physician/Surgeon + Farmington |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Edmund F Ziegler | 87 Lincoln St, New Britain, CT 06052 | Physician/surgeon | 1993-11-10 ~ 1994-10-31 |
| Edmund H Olson Md | 100 Retreat Ave, Hartford, CT 06106 | Physician/surgeon | 2008-06-25 ~ 2009-07-31 |
| Edmund A Ganal | 131 Kent Rd, New Milford, CT 06776-3485 | Physician/surgeon | 2020-08-01 ~ 2021-07-31 |
| Edmund Quinn | 78 Reservoir Ridge Dr, Southington, CT 06489-1356 | Physician/surgeon | 2020-05-01 ~ 2021-04-30 |
| Edmund J Brennan | 299 Forest Ridge Rd, Waterbury, CT 06708 | Physician/surgeon | 2003-03-12 ~ 2004-03-31 |
| Edmund F Hecklau | 36 River Ridge Ct, Stamford, CT 06902 | Physician/surgeon | 2007-05-07 ~ 2008-05-31 |
| Edmund D Marinucci | 13 Oyster Reef Rd, Savannah, GA 31411 | Physician/surgeon | 2007-07-16 ~ 2008-06-30 |
| Edmund Y Chung | 410 Saybrook Rd Suite 201, Middletown, CT 06457 | Physician/surgeon | 2020-03-01 ~ 2021-02-28 |
| Edmund West | Pawcatuck Family Practice, Pawcatuk, CT 06379 | Physician/surgeon | 2020-04-01 ~ 2021-03-31 |
| Edmund Dennis Harris | 22 Llanfair Rd, Unit 6, Ardmore, PA 19003-2320 | Physician/surgeon | 2019-09-20 ~ 2020-08-31 |
Please comment or provide details below to improve the information on EDMUND A 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).