MARK KWALBRUN MD (Credential# 563638) is licensed (Physician/surgeon) with Connecticut Department of Consumer Protection. The license effective date is September 19, 2008. The license expiration date date is August 31, 2009. The license status is INACTIVE.
MARK KWALBRUN MD is licensed with the Department of Consumer Protection of Connecticut. The credential number is #1.046056. The credential type is physician/surgeon. The effective date is September 19, 2008. The expiration date is August 31, 2009. The business address is 340 Derech Ha Avot, 90909. The current status is inactive.
| Licensee Name | MARK KWALBRUN MD |
| Credential ID | 563638 |
| Credential Number | 1.046056 |
| Credential Type | Physician/Surgeon |
| Business Address |
340 Derech Ha Avot 90909 |
| Business Type | INDIVIDUAL |
| Status | INACTIVE - LAPSED DUE TO NON-RENEWAL |
| Issue Date | 2007-12-03 |
| Effective Date | 2008-09-19 |
| Expiration Date | 2009-08-31 |
| Refresh Date | 2009-12-10 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 489603 | CSP.0042907 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 2007-12-17 | 2008-03-31 - 2009-02-28 | INACTIVE |
| Street Address | 340 DERECH HA AVOT |
| Zip Code | 90909 |
| Zip Code | 90909 |
| License Type | Physician/Surgeon |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Mark M Silverstein | Mark Silverstein,md, Manchester, NJ 08759 | Physician/surgeon | 2020-02-01 ~ 2021-01-31 |
| Mark Davis | Po Box 222, Abingdon, MD 21009-0222 | Physician/surgeon | ~ |
| David G Kwalbrun | 1305 Jonathan Lane, Wantagh, NY 11793 | Professional Engineer | 2000-02-01 ~ 2001-01-31 |
| Mark J Harary Md | 31 River Rd Ste 100, Cos Cob, CT 06807-2152 | Physician/surgeon | 2012-06-01 ~ 2013-05-31 |
| Mark I Robbins | 211 Grove Rd, Rye, NH 03870-2508 | Physician/surgeon | 2018-07-01 ~ 2019-06-30 |
| Mark Dam | 15 Barringer Rd, Darien, CT 06820-2012 | Physician/surgeon | 2020-05-01 ~ 2021-04-30 |
| Mark L Friedman | Po Box 298, Newbury, NH 03255-0298 | Physician/surgeon | 2020-03-01 ~ 2021-02-28 |
| Ron Mark | 6 Annette Way, Jericho, NY 11753 | Physician/surgeon | 2019-09-01 ~ 2020-08-31 |
| Mark Levin | 6 Gel Ct, Monsey, NY 10952-1956 | Physician/surgeon | 2020-06-01 ~ 2021-05-31 |
| Mark N Lobato | Ms # 11-tub, Hartford, CT 06134 | Physician/surgeon | 2015-12-01 ~ 2016-11-30 |
Please comment or provide details below to improve the information on MARK KWALBRUN 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).