LISA M CHIRCH (Credential# 1002851) is licensed (Physician/surgeon) with Connecticut Department of Consumer Protection. The license effective date is April 1, 2020. The license expiration date date is March 31, 2021. The license status is ACTIVE.
LISA M CHIRCH is licensed with the Department of Consumer Protection of Connecticut. The credential number is #1.050203. The credential type is physician/surgeon. The effective date is April 1, 2020. The expiration date is March 31, 2021. The business address is Division of Infectious Diseases, Farmington, CT 06030-8076. The current status is active.
| Licensee Name | LISA M CHIRCH |
| Credential ID | 1002851 |
| Credential Number | 1.050203 |
| Credential Type | Physician/Surgeon |
| Business Address |
Division of Infectious Diseases Farmington CT 06030-8076 |
| Business Type | INDIVIDUAL |
| Status | ACTIVE - CURRENT |
| Active | 1 |
| Issue Date | 2011-08-04 |
| Effective Date | 2020-04-01 |
| Expiration Date | 2021-03-31 |
| Refresh Date | 2020-01-06 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 1026374 | CSP.0051084 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 2011-08-05 | 2019-03-01 - 2021-02-28 | ACTIVE |
| Street Address | DIVISION OF INFECTIOUS DISEASES |
| City | Farmington |
| State | CT |
| Zip Code | 06030-8076 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Eric Anthony Brueckner | 263 Farmington Ave., Farmington, CT 06030 | Physician/surgeon | 2020-08-01 ~ 2021-07-31 |
| Derrick B Bremang | Residency Program, Farmington, CT 06030 | Physician/surgeon | 2020-06-01 ~ 2021-06-30 |
| David M Shafer | Uconn Health Center, Farmington, CT 06030 | Dentist | 2020-07-01 ~ 2021-06-30 |
| Michael J Murphy | Dept of Dermatology, Farmington, CT 06030 | Physician/surgeon | 2020-09-01 ~ 2021-08-31 |
| Richard F Kaplan | Univ. of Ct., Farmington, CT 06030 | Psychologist | 2020-06-01 ~ 2021-05-31 |
| Nicholas George Vitale | 22 Woods Drive, Norwich, CT 06030 | Casino Class I Employee | 2019-12-03 ~ 2020-10-31 |
| Bruce E Gould | Univ of Conn Health Center, Farmington, CT 06030 | Physician/surgeon | 2020-04-01 ~ 2021-03-31 |
| Vinayak M Sathe | Uconn Health Center,263 Farmington Ave, Farmington, CT 06030 | Physician/surgeon | 2020-06-01 ~ 2021-05-31 |
| Shobhana Pathani | Department of Medicine, 263 Farmington Ave, CT 06030 | Physician/surgeon | 2020-06-01 ~ 2021-05-31 |
| Patricia L Almeida | John Dempsey Hospital, Farmington, CT 06030 | Registered Nurse | 2020-04-01 ~ 2021-03-31 |
| Find all Licenses in zip 06030 | |||
| City | Farmington |
| Zip Code | 06030 |
| License Type | Physician/Surgeon |
| License Type + County | Physician/Surgeon + Farmington |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Lisa Das | 26 Tamie Way, Pittsfield, MA 01201 | Physician/surgeon | 2000-01-24 ~ 2001-03-31 |
| Lisa J Trencher | 2-11 B Peck Ave, Rye, NY 10580 | Physician/surgeon | 1999-05-20 ~ 2000-05-31 |
| Ana Lisa Carr | Po Box 34457, Omaha, NE 68134-0457 | Physician/surgeon | ~ |
| Nicole M Absar | 58 Lisa Ave, Plymouth, MA 02360-5016 | Physician/surgeon | ~ |
| Lisa V Knopf | 85 Seymour St Ste 815, Hartford, CT 06106-5527 | Physician/surgeon | 2020-06-01 ~ 2021-05-31 |
| Lisa M Cannon | 9 Cedar Dr, Danbury, CT 06810 | Physician/surgeon | 1994-11-18 ~ 1995-09-30 |
| Lisa M Donofrio | 71 Wall St, Madison, CT 06443 | Physician/surgeon | 2020-03-01 ~ 2021-02-28 |
| Lisa I Ramdhanie | 1 Benedict St, Norwalk, CT 06850 | Physician/surgeon | 2020-07-01 ~ 2021-06-30 |
| Lisa Vi Doan | 550 First Avenue, New York, NY 10016 | Physician/surgeon | 2019-05-30 ~ 2020-05-31 |
| Stewart M. Samuel | 7 Lisa Dr, Dix Hills, NY 11746-5103 | Physician/surgeon | 2019-09-01 ~ 2020-08-31 |
Please comment or provide details below to improve the information on LISA M CHIRCH.
| 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).