KEITH R DIXON MD (Credential# 561145) is licensed (Physician/surgeon) with Connecticut Department of Consumer Protection. The license effective date is March 1, 2020. The license expiration date date is February 28, 2021. The license status is ACTIVE.
KEITH R DIXON MD is licensed with the Department of Consumer Protection of Connecticut. The credential number is #1.043563. The credential type is physician/surgeon. The effective date is March 1, 2020. The expiration date is February 28, 2021. The business address is 889 Spring Valley Rd, Maywood, NJ 07607. The current status is active.
| Licensee Name | KEITH R DIXON MD |
| Credential ID | 561145 |
| Credential Number | 1.043563 |
| Credential Type | Physician/Surgeon |
| Business Address |
889 Spring Valley Rd Maywood NJ 07607 |
| Business Type | INDIVIDUAL |
| Status | ACTIVE - CURRENT |
| Active | 1 |
| Issue Date | 2005-06-24 |
| Effective Date | 2020-03-01 |
| Expiration Date | 2021-02-28 |
| Refresh Date | 2020-03-02 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 410823 | CSP.0037807 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 2005-07-19 | 2019-03-01 - 2021-02-28 | ACTIVE |
| Street Address | 889 Spring Valley Rd |
| City | Maywood |
| State | NJ |
| Zip Code | 07607 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Frank S. Ciminello | 113 Essex Street, Maywood, NJ 07607 | Physician/surgeon | 2020-08-01 ~ 2021-07-31 |
| Alim Baycora | 468 Lawrence St, Maywood, NJ 07607 | Professional Engineer | 2020-02-01 ~ 2021-01-31 |
| Heather M Wejnert | 161 West Central Avenue, Maywood, NJ 07607 | Notary Public Appointment | 2011-10-26 ~ 2016-10-31 |
| Aka Finishing Concepts LLC | 90 East Passaic St, Maywood, NJ 07607 | Home Improvement Contractor | 2009-12-01 ~ 2010-11-30 |
| Marc Juceam | 211 Desoto Ave, Maywood, NJ 07607 | Electrical Unlimited Journeyperson | 2014-10-01 ~ 2015-09-30 |
| Dennis V Manas | 26 Grove Avenue, Maywood, NJ 07607 | Registered Nurse | 1998-03-16 ~ 1999-05-31 |
| Anna L Rodriguez | 100 East Hunter Avenue, Maywood, NJ 07607 | Emergency Medical Technician | 2002-04-30 ~ 2004-04-01 |
| Thomas M Loughlin | 176 E. Springvalley Avenue, Maywood, NJ 07607 | Emergency Medical Technician | 2003-10-20 ~ 2006-10-01 |
| Neal A Provenz | 25 E Spring Valley Ave #210, Maywood, NJ 07607 | Real Estate Broker | ~ |
| Grace Z Minnella | Po Box 963, Maywood, NJ 07607-0963 | Acupuncturist | ~ |
| Find all Licenses in zip 07607 | |||
| City | Maywood |
| Zip Code | 07607 |
| License Type | Physician/Surgeon |
| License Type + County | Physician/Surgeon + Maywood |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Peter S Dixon | 192 Westbrook Rd, Essex, CT 06426 | Physician/surgeon | 2020-03-01 ~ 2021-02-28 |
| Duane E Dixon Md | 25 Bateau Way, Plattsburgh, NY 24502 | Physician/surgeon | 2020-06-01 ~ 2021-05-31 |
| Keith C Boldon Md | Keith Boldon Md, Cheshire, CT 06410 | Physician/surgeon | 2020-03-01 ~ 2021-02-28 |
| Valentine J Burroughs | 51 Dixon Dr, Florham Park, NJ 07932-1549 | Physician/surgeon | 2017-07-01 ~ 2018-06-30 |
| Eugene S Pearlman | 710 Dixon Lane, Gladwyne, PA 19035 | Physician/surgeon | 2005-01-10 ~ 2006-01-31 |
| Andrea G Dixon Md | 25 Winterset Ln, West Hartford, CT 06117-1646 | Physician/surgeon | 2020-04-01 ~ 2021-03-31 |
| Elizabeth Marie Dixon | 4025 Anson Ave., Alpharetta, GA 30022 | Physician/surgeon | 2019-11-01 ~ 2020-10-31 |
| Sammie D Dixon | 6104 Forest Lakes Dr, Tifton, GA 31794 | Physician/surgeon | 2009-04-22 ~ 2010-03-31 |
| Ronald Fitzjohn Dixon | 55 Chapel Street Suite 300, Newton, MA 02458 | Physician/surgeon | 2019-10-01 ~ 2020-09-30 |
| Keith A Vom Eigen | 37 Hobson Ave, Windsor, CT 06095 | Physician/surgeon | 2020-01-01 ~ 2020-12-31 |
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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).