KEVIN A. MODESTE (Credential# 1038804) is licensed (Physician/surgeon) with Connecticut Department of Consumer Protection. The license effective date is April 1, 2012. The license expiration date date is March 31, 2013. The license status is INACTIVE.
KEVIN A. MODESTE is licensed with the Department of Consumer Protection of Connecticut. The credential number is #1.050452. The credential type is physician/surgeon. The effective date is April 1, 2012. The expiration date is March 31, 2013. The business address is Uconn Health Ctr, Mc-3955, CT 06030. The current status is inactive.
| Licensee Name | KEVIN A. MODESTE |
| Credential ID | 1038804 |
| Credential Number | 1.050452 |
| Credential Type | Physician/Surgeon |
| Business Address |
Uconn Health Ctr Mc-3955 CT 06030 |
| Business Type | INDIVIDUAL |
| Status | INACTIVE - LAPSED DUE TO NON-RENEWAL |
| Issue Date | 2011-11-23 |
| Effective Date | 2012-04-01 |
| Expiration Date | 2013-03-31 |
| Refresh Date | 2013-07-03 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 448915 | CSP.0040511 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 2006-12-04 | 2011-12-16 - 2013-02-28 | INACTIVE |
| Street Address | UCONN HEALTH CTR |
| City | MC-3955 |
| State | CT |
| Zip Code | 06030 |
| 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 | MC-3955 |
| Zip Code | 06030 |
| License Type | Physician/Surgeon |
| License Type + County | Physician/Surgeon + MC-3955 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Kevin J Tally | 16 Rip Rd, Hanover, NH 03755-1614 | Physician/surgeon | 2020-05-01 ~ 2021-04-30 |
| Kevin Y Pei | Po Box 208062, New Haven, CT 06520 | Physician/surgeon | 2018-06-01 ~ 2019-05-31 |
| Kevin L Soe | 26 Jasmine Dr, Middletown, NY 10940-5046 | Physician/surgeon | 2015-08-01 ~ 2016-07-31 |
| Kevin W Dickey Md | Po Box 217, New Britain, CT 06050-0217 | Physician/surgeon | 2014-09-01 ~ 2015-08-31 |
| Kevin J Finkel Md | 100 Retreat Ave, # 900, Hartford, CT 06106 | Physician/surgeon | 2020-06-01 ~ 2021-05-31 |
| Kevin M Johnson Md | 19 Stanton Ct, Madison, CT 06443 | Physician/surgeon | 2020-06-01 ~ 2021-05-31 |
| Kevin R Dougherty | 85 Seymour St Ste 719, Hartford, CT 06106-5526 | Physician/surgeon | 2020-07-01 ~ 2021-06-30 |
| Kevin O'gara Do | Po Box 618, Pleasant Valley, CT 06063-0618 | Physician/surgeon | 2020-05-01 ~ 2021-04-30 |
| Kevin M Schuster Md | 21 Cedar Rd, Woodbridge, CT 06525-1642 | Physician/surgeon | 2020-08-01 ~ 2021-07-31 |
| Kevin P Becker | 37 Quail Run, Madison, CT 06443-1946 | Physician/surgeon | 2020-03-01 ~ 2021-02-28 |
Please comment or provide details below to improve the information on KEVIN A. MODESTE.
| 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).