LEE J SECRIST MD (Credential# 561219) is licensed (Physician/surgeon) with Connecticut Department of Consumer Protection. The license effective date is March 1, 2013. The license expiration date date is February 28, 2014. The license status is INACTIVE.
LEE J SECRIST MD is licensed with the Department of Consumer Protection of Connecticut. The credential number is #1.043637. The credential type is physician/surgeon. The effective date is March 1, 2013. The expiration date is February 28, 2014. The business address is Po Box 2127, Coeur D Alene, ID 83816. The current status is inactive.
| Licensee Name | LEE J SECRIST MD |
| Credential ID | 561219 |
| Credential Number | 1.043637 |
| Credential Type | Physician/Surgeon |
| Business Address |
Po Box 2127 Coeur D Alene ID 83816 |
| Business Type | INDIVIDUAL |
| Status | INACTIVE - LAPSED DUE TO NON-RENEWAL |
| Issue Date | 2005-07-12 |
| Effective Date | 2013-03-01 |
| Expiration Date | 2014-02-28 |
| Refresh Date | 2014-06-03 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 413798 | CSP.0038040 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 2005-08-17 | 2011-03-01 - 2013-02-28 | INACTIVE |
| Street Address | PO Box 2127 |
| City | Coeur D Alene |
| State | ID |
| Zip Code | 83816 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Samuel William S'doia | P.o. 1619, Coeur D'alene, ID 83816 | Physician/surgeon | 2020-09-01 ~ 2021-08-31 |
| Troy A Belle | Direct Radiology, Coeur D'alene, ID 83816 | Physician/surgeon | 2020-06-01 ~ 2021-05-31 |
| John Robert Blackwell | P.o. Box 1619, Coeur D'alene, ID 83816 | Physician/surgeon | ~ |
| John W Boardman | Po Box 1619, Coeur D Alene, ID 83816-1619 | Controlled Substance Registration for Practitioner | 2011-03-01 ~ 2013-02-28 |
| Suzanne Lei Aquino | Po Box 1619, Coeur D Alene, ID 83816-1619 | Physician/surgeon | ~ |
| Shree Jayendra Shah | Po Box 1619, Coeur D Alene, ID 83816-1619 | Physician/surgeon | ~ |
| Dishant Girish Shah | Po Box 1619, Coeur D Alene, ID 83816-1619 | Physician/surgeon | ~ |
| William Joseph Rusnak | Po Box 1619, Coeur D Alene, ID 83816-1619 | Physician/surgeon | ~ |
| Patrick Joseph Burke | Po Box 1619, Coeur D Alene, ID 83816-1619 | Physician/surgeon | ~ |
| Syed Ali Akbar | Po Box 1619, Coeur D Alene, ID 83816-1619 | Physician/surgeon | ~ |
| Find all Licenses in zip 83816 | |||
| City | Coeur D Alene |
| Zip Code | 83816 |
| License Type | Physician/Surgeon |
| License Type + County | Physician/Surgeon + Coeur D Alene |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Penny Lamhut Md | Genesis Physician Services, Windsor, CT 06098 | Physician/surgeon | 1999-07-15 ~ 2000-07-31 |
| Russell H Harris Md | Envision Physician Services, Horsham, PA 19044 | Physician/surgeon | 2019-09-01 ~ 2020-08-31 |
| Gilbert L Drozdow | Envision Physician Services, Plantation, FL 33322 | Physician/surgeon | 2019-10-01 ~ 2020-09-30 |
| John T Thompson | Physician Pavilion W, Towson, MD 21204 | Physician/surgeon | 2020-07-01 ~ 2021-06-30 |
| Arnold R Kriegstein | College Physician, New York, NY 10032 | Physician/surgeon | 1993-04-23 ~ 1994-03-31 |
| Catherine Nguyen Keegan | Envision Physician Services, Dallas, TX 75240 | Physician/surgeon | 2020-02-01 ~ 2021-01-31 |
| Brent Robert Jacobson | Envision Physician Services, Dallas, TX 75240 | Physician/surgeon | 2020-09-01 ~ 2021-08-31 |
| Nazanin Barzideh Md | North Shore Retina Physician, Pllc, East Hills, NY 11576 | Physician/surgeon | 2010-05-01 ~ 2011-04-30 |
| Barbara M Galko Md | Danbury Office of Physician Services PC, Danbury, CT 06810 | Physician/surgeon | 2010-06-01 ~ 2011-05-31 |
| Susan J Batlan Md | Eye Physician Associates of Hartford, West Hartford, CT 06107 | Physician/surgeon | 2000-07-27 ~ 2001-07-31 |
Please comment or provide details below to improve the information on LEE J SECRIST 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).