GREGORY KLISCH MD (Credential# 564314) is licensed (Physician/surgeon) with Connecticut Department of Consumer Protection. The license effective date is August 1, 2013. The license expiration date date is July 31, 2014. The license status is INACTIVE.
GREGORY KLISCH MD is licensed with the Department of Consumer Protection of Connecticut. The credential number is #1.046732. The credential type is physician/surgeon. The effective date is August 1, 2013. The expiration date is July 31, 2014. The business address is 11995 Singletree Ln Ste 500, Eden Prairie, MN 55344-5349. The current status is inactive.
| Licensee Name | GREGORY KLISCH MD |
| Credential ID | 564314 |
| Credential Number | 1.046732 |
| Credential Type | Physician/Surgeon |
| Business Address |
11995 Singletree Ln Ste 500 Eden Prairie MN 55344-5349 |
| Business Type | INDIVIDUAL |
| Status | INACTIVE - LAPSED DUE TO NON-RENEWAL |
| Issue Date | 2008-07-01 |
| Effective Date | 2013-08-01 |
| Expiration Date | 2014-07-31 |
| Refresh Date | 2014-11-03 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 516313 | CSP.0044713 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 2008-10-16 | 2011-03-01 - 2013-02-28 | INACTIVE |
| Street Address | 11995 SINGLETREE LN STE 500 |
| City | EDEN PRAIRIE |
| State | MN |
| Zip Code | 55344-5349 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Ira M Tyler | 11995 Singletree Ln Ste 500, Eden Prairie, MN 55344-5349 | Physician/surgeon | 2020-07-01 ~ 2021-06-30 |
| Arlene Sussman | 11995 Singletree Ln Ste 500, Eden Prairie, MN 55344-5349 | Physician/surgeon | 2020-07-01 ~ 2021-06-30 |
| Albert C Ybasco | 11995 Singletree Ln Ste 500, Eden Prairie, MN 55344-5349 | Physician/surgeon | 2020-07-01 ~ 2021-06-30 |
| Gregg P Sydow | 11995 Singletree Ln Ste 500, Eden Prairie, MN 55344-5349 | Physician/surgeon | 2020-07-01 ~ 2021-06-30 |
| Scott R Kerns | 11995 Singletree Ln Ste 500, Eden Prairie, MN 55344-5349 | Physician/surgeon | 2020-07-01 ~ 2021-06-30 |
| Jennifer Sur Gutierrez | 11995 Singletree Ln Ste 500, Eden Prairie, MN 55344-5349 | Physician/surgeon | 2020-06-01 ~ 2021-05-31 |
| Reem S Awwad | 11995 Singletree Ln Ste 500, Eden Prairie, MN 55344-5349 | Physician/surgeon | 2020-06-01 ~ 2021-05-31 |
| Alan S Muraki | 11995 Singletree Ln Ste 500, Eden Prairie, MN 55344-5349 | Physician/surgeon | 2020-05-01 ~ 2021-04-30 |
| Steven B Edson | 11995 Singletree Ln Ste 500, Eden Prairie, MN 55344-5349 | Physician/surgeon | 2020-05-01 ~ 2021-04-30 |
| Bruce J Thaler | 11995 Singletree Ln Ste 500, Eden Prairie, MN 55344-5349 | Physician/surgeon | 2020-04-01 ~ 2021-03-31 |
| Find all Licenses in the same address | |||
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Richard L Toothman | 11995 Singletree Ln, Ste 500, Eden Prairie, MN 55344-5349 | Physician/surgeon | 2015-12-01 ~ 2016-11-30 |
| Christian Binder | Suite 500, Eden Prairie, MN 55344-5349 | Physician/surgeon | 2012-02-01 ~ 2013-01-31 |
| Priti B Ram Md | 11995 Singletree Lane, Ste 500, Eden Prairie, MN 55344-5349 | Physician/surgeon | 2018-02-01 ~ 2019-01-31 |
| Peter D Holt | 11995 Singletree Lane, Ste 500, Eden Prairie, MN 55344-5349 | Physician/surgeon | 2015-05-01 ~ 2016-04-30 |
| Eduard Michel | 11995 Singletree Ln, Eden Prairie, MN 55344-5349 | Physician/surgeon | 2010-05-01 ~ 2011-04-30 |
| Richard S Chang | 11995 Singletree Ln, Eden Prairie, MN 55344-5349 | Physician/surgeon | 2010-03-01 ~ 2011-02-28 |
| 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 |
| 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 |
| 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 |
|---|---|---|---|
| Klisch Pilsner Beer | Connecticut Brand Registration, Hartford, CT 06106 | Liquor Brand Label | 2007-08-02 ~ 2010-08-01 |
| Gregory C Cadman | 7 Lighthouse Ln, Old Greenwich, CT 06870-2310 | Physician/surgeon | ~ |
| Gregory W Taylor | 56 Republic Dr Apt 315, Bloomfield, CT 06002-5442 | Physician/surgeon | 2020-05-01 ~ 2021-04-30 |
| Gregory V Babigian | 18 Harness Rd, St. James, NY 11780 | Physician/surgeon | 2019-09-01 ~ 2020-08-31 |
| Gregory K Buller | 267 Grant St, Bridgeport, CT 06610-2805 | Physician/surgeon | 2020-03-01 ~ 2021-02-28 |
| Alani Gregory | 275 Winchester Ave, New Haven, CT 06511 | Physician/surgeon | 2018-10-01 ~ 2019-09-30 |
| Gregory W Walter | 22 Monticello Key, Papamoa Tauranga, 3118 | Physician/surgeon | ~ |
| Gregory Lombardo | 6 Lyndel Rd, Pound Ridge, NY 10576 | Physician/surgeon | ~ |
| Gregory P Geba Md | 5 Douglas Dr, Sparta, NJ 07871 | Physician/surgeon | 2020-01-01 ~ 2020-12-31 |
| Gregory Slachta Md | 222 Carew St, Springfield, MA 01104 | Physician/surgeon | 1997-01-13 ~ 1998-03-31 |
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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).