MINA KIM MD (Credential# 559855) is licensed (Physician/surgeon) with Connecticut Department of Consumer Protection. The license effective date is December 1, 2016. The license expiration date date is November 30, 2017. The license status is INACTIVE.
MINA KIM MD is licensed with the Department of Consumer Protection of Connecticut. The credential number is #1.042273. The credential type is physician/surgeon. The effective date is December 1, 2016. The expiration date is November 30, 2017. The business address is 190 Saddle Ridge Rd, Southbury, CT 06488-4709. The current status is inactive.
| Licensee Name | MINA KIM MD |
| Credential ID | 559855 |
| Credential Number | 1.042273 |
| Credential Type | Physician/Surgeon |
| Business Address |
190 Saddle Ridge Rd Southbury CT 06488-4709 |
| Business Type | INDIVIDUAL |
| Status | INACTIVE - LAPSED DUE TO NON-RENEWAL |
| Issue Date | 2004-03-31 |
| Effective Date | 2016-12-01 |
| Expiration Date | 2017-11-30 |
| Refresh Date | 2018-03-05 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 366412 | CSP.0034795 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 2004-05-25 | 2013-03-01 - 2015-02-28 | INACTIVE |
| Street Address | 190 SADDLE RIDGE RD |
| City | SOUTHBURY |
| State | CT |
| Zip Code | 06488-4709 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Laurie M Bernardi | 128 Saddle Ridge Rd, Southbury, CT 06488-4709 | Real Estate Salesperson | 2020-06-01 ~ 2021-05-31 |
| Karen L Flanagan | 187 Saddle Ridge Rd, Southbury, CT 06488-4709 | Professional Counselor | 2020-01-01 ~ 2020-12-31 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Jillian Jung | 582 Patriot Rd, Southbury, CT 06488 | Radiographer | 2020-08-01 ~ 2021-07-31 |
| Mary E Kohler | 201 Old Highway, Southbury, CT 06488 | Registered Nurse | 2020-09-01 ~ 2021-08-31 |
| Theresa K Bobak | 266b Heritage Village, Southbury, CT 06488 | Registered Nurse | 2020-08-01 ~ 2021-07-31 |
| Kelly Watson | 800 Main Street South Suite 102, Southbury, CT 06488 | Medication Administration Certification | 2018-06-27 ~ 2020-06-26 |
| Mcdonald's Rest #2104 | 44 Division St, Derby, CT 06488 | Bakery | 2020-07-01 ~ 2021-06-30 |
| Shirley A Frager | 5 West View Rd, Southbury, CT 06488 | Registered Nurse | 2020-07-01 ~ 2021-06-30 |
| Maureen K Boyd | 77 Shane Drive, Southbury, CT 06488 | Physical Therapist | 2020-09-01 ~ 2021-08-31 |
| South Britain Oil LLC | 424 Old Field Rd, Southbury, CT 06488 | Operator of Weighing & Measuring Devices | 2020-08-01 ~ 2021-07-31 |
| Won Ju Lee | 995 Old Field Rd, Southbury, CT 06488 | Combination Nail Technician, Esthetician Or Eyelash Technici | 2020-06-26 ~ 2022-01-31 |
| Mcdonald's Rest #27001 | 652 New Haven Ave, Derby, CT 06488 | Bakery | 2020-07-01 ~ 2021-06-30 |
| Find all Licenses in zip 06488 | |||
| City | SOUTHBURY |
| Zip Code | 06488 |
| License Type | Physician/Surgeon |
| License Type + County | Physician/Surgeon + SOUTHBURY |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Mina Farkhondeh | 115 Elm St, Enfield, CT 06082-3712 | Physician/surgeon | 2020-07-01 ~ 2021-06-30 |
| Mina L Xu | 360 State St Apt 3105, New Haven, CT 06510 | Physician/surgeon | 2020-07-01 ~ 2021-06-30 |
| Mina R Rasoulpour | 9 Wentworth Park, Farmington, CT 06032-1559 | Physician/surgeon | 2016-06-01 ~ 2017-05-31 |
| Mina Safwat Sobhi Fanous | 222 Lenox Rd, Brooklyn, NY 11226 | Physician/surgeon | 2018-09-10 ~ 2018-11-30 |
| Mina Fatimah Obbehat | 127 Colwyn Lane, Bala Cynwyd, PA 19004 | Physician/surgeon | 2020-01-01 ~ 2020-12-31 |
| Mina Foods Inc · Mina Foods | 100 Research Dr, Milford, CT 06460-2838 | Ct Out of State Shipper Beer | 2020-08-12 ~ 2021-08-11 |
| Mina Mina | Uconn Health Center Rm L6082, Farmington, CT 06032 | Dentist | 2020-05-01 ~ 2021-04-30 |
| Akram Aldahabi · Mina's Market | 1905 Central Ave, Bridgeport, CT 06610 | Grocery Beer | 1999-02-11 ~ 2000-02-10 |
| Manook and Mina | 2 Oleander Dr, Clinton, CT 06413-1079 | Vending Machine Operator | 2013-11-13 ~ 2014-06-30 |
| Mina Foods | 100 Research Dr, Milford, CT 06460-2838 | Milk Sub-dealer | 2020-07-01 ~ 2022-06-30 |
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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).