DAVID I THICKMAN MD (Credential# 562231) is licensed (Physician/surgeon) with Connecticut Department of Consumer Protection. The license effective date is December 1, 2015. The license expiration date date is November 30, 2016. The license status is INACTIVE.
DAVID I THICKMAN MD is licensed with the Department of Consumer Protection of Connecticut. The credential number is #1.044649. The credential type is physician/surgeon. The effective date is December 1, 2015. The expiration date is November 30, 2016. The business address is 11995 Singletree Lane, Eden Prairie, MN 55344. The current status is inactive.
| Licensee Name | DAVID I THICKMAN MD |
| Credential ID | 562231 |
| Credential Number | 1.044649 |
| Credential Type | Physician/Surgeon |
| Business Address |
11995 Singletree Lane Eden Prairie MN 55344 |
| Business Type | INDIVIDUAL |
| Status | INACTIVE - LAPSED DUE TO NON-RENEWAL |
| Issue Date | 2006-08-03 |
| Effective Date | 2015-12-01 |
| Expiration Date | 2016-11-30 |
| Refresh Date | 2017-03-05 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 449597 | CSP.0040565 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 2006-09-11 | 2011-03-01 - 2013-02-28 | INACTIVE |
| Street Address | 11995 Singletree Lane |
| City | Eden Prairie |
| State | MN |
| Zip Code | 55344 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Donald T Nicell | 11995 Singletree Lane, Eden Prairie, MN 55344 | Physician/surgeon | 2020-08-01 ~ 2021-07-31 |
| Alan J Kopp | 11995 Singletree Lane, Eden Prairie, MN 55344 | Physician/surgeon | 2020-08-01 ~ 2021-07-31 |
| Jennifer Kim Md | 11995 Singletree Lane, Eden Prairie, MN 55344 | Physician/surgeon | 2020-08-01 ~ 2021-07-31 |
| Joseph Michael Rozell | 11995 Singletree Lane, Eden Prairie, MN 55344 | Physician/surgeon | 2020-07-01 ~ 2021-06-30 |
| Jeffrey Brian Cutler | 11995 Singletree Lane, Eden Prairie, MN 55344 | Physician/surgeon | 2020-06-01 ~ 2021-05-31 |
| Wendy Elaine Zimmer | 11995 Singletree Lane, Eden Prairie, MN 55344 | Physician/surgeon | 2020-06-01 ~ 2021-05-31 |
| Richard T. Kaplan | 11995 Singletree Lane, Eden Prairie, MN 55344 | Physician/surgeon | 2020-06-01 ~ 2021-05-31 |
| Kevin Charles Wright | 11995 Singletree Lane, Eden Prairie, MN 55344 | Physician/surgeon | 2020-05-01 ~ 2021-04-30 |
| Raymond Bozman | 11995 Singletree Lane, Eden Prairie, MN 55344 | Physician/surgeon | 2020-04-01 ~ 2021-03-31 |
| Christopher M. Garcia | 11995 Singletree Lane, Eden Prairie, MN 55344 | Physician/surgeon | 2020-04-01 ~ 2021-03-31 |
| Find all Licenses in the same address | |||
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Neuroone Medical Technologies Corp | 7599 Anagram Dr, Eden Prairie, MN 55344 | Securities - Exemptions | 2020-05-15 ~ |
| Robert Edward Stone | 11995 Singletree Lane, Ste 500, Eden Prairie, MN 55344 | Physician/surgeon | 2020-07-01 ~ 2021-06-30 |
| Daniel James Tangert | 6400 Fallbrook Rd., Eden Prairie, MN 55344 | Registered Nurse | 2020-05-01 ~ 2021-04-30 |
| Dmitry Bolkhovets | 11995 Singletree Ln, Eden Prairie, MN 55344 | Physician/surgeon | 2020-05-01 ~ 2021-04-30 |
| Zinpro | 104000 Vikings Drive, Suite 240, Eden Prairie, MN 55344 | Commercial Feed | 2020-03-05 ~ 2020-12-31 |
| Michael Wallace Sentome | 11995 Singletree Lane, Suite 500, Eden Prairie, MN 55344 | Physician/surgeon | 2020-05-01 ~ 2021-04-30 |
| Stephanie Denise Johnson | 8423 Cortland Rd, Eden Prairie, MN 55344 | Registered Nurse | 2020-06-01 ~ 2021-05-31 |
| Ashley Nicole Ingram | 11000 Optum Circle, Eden Prairie, MN 55344 | Registered Nurse | 2020-01-16 ~ 2020-08-31 |
| Colleen M Steven | 13900 Chestnut Drive # 208, Eden Prarie, MN 55344 | Registered Nurse | 2019-12-01 ~ 2020-11-30 |
| Rebecca Dipofi Rogers | 13625 Technology Dr, Eden Prairie, MN 55344 | Registered Nurse | 2019-09-01 ~ 2020-08-31 |
| Find all Licenses in zip 55344 | |||
| City | Eden Prairie |
| Zip Code | 55344 |
| License Type | Physician/Surgeon |
| License Type + County | Physician/Surgeon + Eden Prairie |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Susan C Thickman | 663 Mulholand Dr, Ripon, CA 95366-2155 | Physical Therapist | 2013-10-01 ~ 2014-09-30 |
| David M Renison | Po Box 75, Middletown, CT 06457-0075 | Physician/surgeon | 2013-07-01 ~ 2014-06-30 |
| David Chu Md | 358 W Hyerdale Dr, Goshen, CT 06756 | Physician/surgeon | 2020-05-01 ~ 2021-04-30 |
| David Brian Feig | 701 5th Ave, Seattle, WA 98104 | Physician/surgeon | ~ |
| David P Roy | 184 East St, Plainville, CT 06062-2913 | Physician/surgeon | 2020-04-01 ~ 2021-03-31 |
| David D Giardina | 10 Little Fox La, Westport, CT 06880 | Physician/surgeon | 2004-07-06 ~ 2005-07-31 |
| David R Widrow Md | 22 Fifth St, Stamford, CT 06905 | Physician/surgeon | 2002-08-20 ~ 2003-10-31 |
| David J Rea | 5699 N Centerpark Way Apt 502, Glendale, WI 53217-4571 | Physician/surgeon | ~ |
| David J Martin | C/o O.s.m., Trumbull, CT 06611 | Physician/surgeon | 2019-12-01 ~ 2020-11-30 |
| David M Drvaric | 516 Carew St, Springfield, MA 01104-2330 | Physician/surgeon | ~ |
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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).