DONNA M POLK MD (Credential# 564218) is licensed (Physician/surgeon) with Connecticut Department of Consumer Protection. The license effective date is November 1, 2017. The license expiration date date is October 31, 2018. The license status is INACTIVE.
DONNA M POLK MD is licensed with the Department of Consumer Protection of Connecticut. The credential number is #1.046636. The credential type is physician/surgeon. The effective date is November 1, 2017. The expiration date is October 31, 2018. The business address is 9 Long Hill Rd, North Yarmouth, ME 04097-6049. The current status is inactive.
Licensee Name | DONNA M POLK MD |
Credential ID | 564218 |
Credential Number | 1.046636 |
Credential Type | Physician/Surgeon |
Business Address |
9 Long Hill Rd North Yarmouth ME 04097-6049 |
Business Type | INDIVIDUAL |
Status | INACTIVE - LAPSED DUE TO NON-RENEWAL |
Issue Date | 2008-06-11 |
Effective Date | 2017-11-01 |
Expiration Date | 2018-10-31 |
Refresh Date | 2019-02-03 |
ID | Credential Code | Credential Type | Issue | Term | Status |
---|---|---|---|---|---|
506768 | CSP.0043718 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 2008-07-01 | 2011-03-01 - 2013-02-28 | INACTIVE |
Street Address | 9 LONG HILL RD |
City | NORTH YARMOUTH |
State | ME |
Zip Code | 04097-6049 |
Licensee Name | Office Address | Credential | Effective / Expiration |
---|---|---|---|
Kimberly H Powers | 473 Gray Road, North Yarmouth, ME 04097 | Professional Engineer | 2020-02-01 ~ 2021-01-31 |
David A Price | 75 Farms Edge Rd, N Yarmouth, ME 04097 | Professional Engineer | 2020-02-01 ~ 2021-01-31 |
Richard N Davee | 15 Brookview Lane, North Yarmouth, ME 04097 | Professional Engineer | 2020-02-01 ~ 2021-01-31 |
Laraine E Derrig | 357 Greely Rd Ext, North Yarmouth, ME 04097 | Registered Nurse | 2011-07-01 ~ 2012-06-30 |
Joseph G Paolino | 554 Sligo Road, N Yarmouth, ME 04097 | Heating, Piping & Cooling Limited Journeyperson | 2009-10-06 ~ 2010-08-31 |
Michelle Labonte | 62 Rayberry Drive, North Yarmouth, ME 04097 | Registered Nurse | 2009-12-01 ~ 2010-11-30 |
Sarah B Morrison | 75 Cumberland Rd, N Yarmouth, ME 04097 | Architect | 1996-08-01 ~ 1997-07-31 |
Jacqueline B Vaniotis | 172 Haskell Road, North Yarmouth, ME 04097 | Registered Nurse | 2008-11-17 ~ 2010-01-31 |
Janice P Weaver | 246 Memorial Hwy, North Yarmouth, ME 04097 | Registered Nurse | 2000-09-27 ~ 2001-11-30 |
James W Shrum | 186 New Gloucester Rd, North Yarmouth, ME 04097-6125 | Registered Nurse | 2017-11-01 ~ 2018-10-31 |
Find all Licenses in zip 04097 |
City | NORTH YARMOUTH |
Zip Code | 04097 |
License Type | Physician/Surgeon |
License Type + County | Physician/Surgeon + NORTH YARMOUTH |
Licensee Name | Office Address | Credential | Effective / Expiration |
---|---|---|---|
Kays Kaysi | 42 Polk Blvd, Greenville, SC 29611-7821 | Physician/surgeon | ~ |
Donna L Henig | CT | Physician/surgeon | ~ |
Alice Donna Kim | 29 E 7th St Apt 4w, New York, NY 10003-8021 | Physician/surgeon | 2020-03-01 ~ 2021-02-28 |
Steven L Berk Md | 8 Donna Rd, Worcester, MA 01609-1145 | Physician/surgeon | 2016-06-01 ~ 2017-05-31 |
Donna M Boruchov | 94 Deer Run, Avon, CT 06001 | Physician/surgeon | 2020-08-01 ~ 2021-07-31 |
Donna E Coletti | 4 Charter Oak Ln, Greenwich, CT 06830-6911 | Physician/surgeon | 2020-05-01 ~ 2021-04-30 |
Donna C Sinclair Md | 788 Rutland Ct, Lithonia, GA 30058-3200 | Physician/surgeon | 2010-06-01 ~ 2011-05-31 |
Donna Phanumas Md | 12 Carlton Ave, Yonkers, NY 10710 | Physician/surgeon | 2020-06-01 ~ 2021-05-31 |
Donna M Mchugh Md | 115 Spencer St, Winsted, CT 06098 | Physician/surgeon | 2020-05-01 ~ 2021-04-30 |
Donna L O'shea | 93 Brittany Ln, Somers, CT 06071-1137 | Physician/surgeon | 2019-09-01 ~ 2020-08-31 |
Please comment or provide details below to improve the information on DONNA M POLK 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).