KEITH A HERNANDEZ MD (Credential# 562453) 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.
KEITH A HERNANDEZ MD is licensed with the Department of Consumer Protection of Connecticut. The credential number is #1.044871. The credential type is physician/surgeon. The effective date is June 1, 2020. The expiration date is May 31, 2021. The business address is 193 River Rd, Madison, CT 06443. The current status is active.
Licensee Name | KEITH A HERNANDEZ MD |
Credential ID | 562453 |
Credential Number | 1.044871 |
Credential Type | Physician/Surgeon |
Business Address |
193 River Rd Madison CT 06443 |
Business Type | INDIVIDUAL |
Status | ACTIVE - CURRENT |
Active | 1 |
Issue Date | 2006-10-30 |
Effective Date | 2020-06-01 |
Expiration Date | 2021-05-31 |
Refresh Date | 2020-04-16 |
ID | Credential Code | Credential Type | Issue | Term | Status |
---|---|---|---|---|---|
380950 | CSP.0036228 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 2004-09-10 | 2019-03-01 - 2021-02-28 | ACTIVE |
458048 | CSP.0040954 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | - | INACTIVE |
Street Address | 193 River Rd |
City | Madison |
State | CT |
Zip Code | 06443 |
Licensee Name | Office Address | Credential | Effective / Expiration |
---|---|---|---|
Caitlyn Beverly Darosa | Lyle Dr, Madison, CT 06443 | Registered Nurse | ~ |
Roberts Food Center · Rjf Inc Dba | 514 Old Toll Rd, Madison, CT 06443 | Operator of Weighing & Measuring Devices | 2020-08-01 ~ 2021-07-31 |
Karen D Leonetti · Rapuano | 553 Green Hill Rd, Madison, CT 06443 | Radiographer | 2020-09-01 ~ 2021-08-31 |
Pasquale Sabatasso | 122 River Edge Farms Road, Madison, CT 06443 | Barber | 2020-07-01 ~ 2022-06-30 |
Madision Health Foods · Jum Ok Coker | 59 Wall St, Madison, CT 06443 | Operator of Weighing & Measuring Devices | 2020-08-01 ~ 2021-07-31 |
Madison Community Services Inc. | P.o. Box 148, Madison, CT 06443 | Public Charity | 2020-12-01 ~ 2021-11-30 |
Shaina Michele Levinson | 52 East Wharf Rd, Madison, CT 06443 | Master's Level Social Worker | ~ |
Stephen G Lynch · Lynch, Stephen Gerard | 12 Milestone Lane, Madison, CT 06443 | Real Estate Salesperson | 2020-06-01 ~ 2021-05-31 |
David F Courtney Md | 38 Old Duck Hole Road, Madison, CT 06443 | Physician/surgeon | 2020-07-01 ~ 2021-06-30 |
Sydni E Marmor | 560 Opening Hill Road, Madison, CT 06443 | Professional Counselor | 2020-07-01 ~ 2021-06-30 |
Find all Licenses in zip 06443 |
City | Madison |
Zip Code | 06443 |
License Type | Physician/Surgeon |
License Type + County | Physician/Surgeon + Madison |
Licensee Name | Office Address | Credential | Effective / Expiration |
---|---|---|---|
Keith C Boldon Md | Keith Boldon Md, Cheshire, CT 06410 | Physician/surgeon | 2020-03-01 ~ 2021-02-28 |
Julian Hernandez | Po Box 10370, Holyoke, MA 01041-1970 | Physician/surgeon | 2019-11-01 ~ 2020-10-31 |
Frank Hernandez | 21 Knollwood Rd, Farmington, CT 06032-1048 | Physician/surgeon | 2012-05-01 ~ 2013-04-30 |
Juan R Hernandez | 27 Nettleton Drive, Woodbridge, CT 06525 | Physician/surgeon | 2020-03-01 ~ 2021-02-28 |
Hillary S Hernandez-trujillo | 282 Washington St, Hartford, CT 06106 | Physician/surgeon | 2020-07-01 ~ 2021-06-30 |
Angelica M Hernandez | 69 Gold Street, New York, NY 10038 | Physician/surgeon | 2003-10-24 ~ 2004-10-31 |
Camilo Pena Hernandez | 6310 75th St, Lubbock, TX 79424-1942 | Physician/surgeon | ~ |
Carlos A Hernandez-avila | 11 Ridgeview Dr, Farmington, CT 06032 | Physician/surgeon | 2020-02-01 ~ 2021-01-31 |
Jorge E Hernandez | 201 Regan Road #17a, Vernon, CT 06066 | Physician/surgeon | 1995-09-27 ~ 1996-09-30 |
Juan M Hernandez-trujillo | 2475 North Ave, Bridgeport, CT 06604 | Physician/surgeon | 2004-09-15 ~ 2005-11-30 |
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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).