KATHERINE H GOODRICH MD
Physician/surgeon


Address: 190 Waite St Fl 2, Hamden, CT 06517-2529

KATHERINE H GOODRICH MD (Credential# 564655) is licensed (Physician/surgeon) with Connecticut Department of Consumer Protection. The license effective date is April 1, 2010. The license expiration date date is March 31, 2011. The license status is INACTIVE.

Business Overview

KATHERINE H GOODRICH MD is licensed with the Department of Consumer Protection of Connecticut. The credential number is #1.047073. The credential type is physician/surgeon. The effective date is April 1, 2010. The expiration date is March 31, 2011. The business address is 190 Waite St Fl 2, Hamden, CT 06517-2529. The current status is inactive.

Basic Information

Licensee Name KATHERINE H GOODRICH MD
Credential ID 564655
Credential Number 1.047073
Credential Type Physician/Surgeon
Business Address 190 Waite St Fl 2
Hamden
CT 06517-2529
Business Type INDIVIDUAL
Status INACTIVE - LAPSED DUE TO NON-RENEWAL
Issue Date 2008-10-07
Effective Date 2010-04-01
Expiration Date 2011-03-31
Refresh Date 2011-08-11

Other licenses

ID Credential Code Credential Type Issue Term Status
523968 CSP.0045068 CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER 2009-02-02 - 2011-02-28 INACTIVE

Office Location

Street Address 190 WAITE ST FL 2
City HAMDEN
State CT
Zip Code 06517-2529

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Keleann T Tamaki 165 Ridge Road, Hamden, CT 06517 Registered Nurse 2020-09-01 ~ 2021-08-31
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City HAMDEN
Zip Code 06517
License Type Physician/Surgeon
License Type + County Physician/Surgeon + HAMDEN

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Dataset Information

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).

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