DAVID M. ROBERTSON (Credential# 1078078) is licensed (Physician/surgeon) with Connecticut Department of Consumer Protection. The license effective date is August 1, 2014. The license expiration date date is July 31, 2015. The license status is INACTIVE.
DAVID M. ROBERTSON is licensed with the Department of Consumer Protection of Connecticut. The credential number is #1.051309. The credential type is physician/surgeon. The effective date is August 1, 2014. The expiration date is July 31, 2015. The business address is 354 Birnie Ave, Springfield, MA 01107-1108. The current status is inactive.
| Licensee Name | DAVID M. ROBERTSON |
| Credential ID | 1078078 |
| Credential Number | 1.051309 |
| Credential Type | Physician/Surgeon |
| Business Address |
354 Birnie Ave Springfield MA 01107-1108 |
| Business Type | INDIVIDUAL |
| Status | INACTIVE - LAPSED DUE TO NON-RENEWAL |
| Issue Date | 2012-08-16 |
| Effective Date | 2014-08-01 |
| Expiration Date | 2015-07-31 |
| Refresh Date | 2015-11-03 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 1122646 | CSP.0053709 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 2012-09-17 | 2013-03-01 - 2015-02-28 | INACTIVE |
| Street Address | 354 BIRNIE AVE |
| City | SPRINGFIELD |
| State | MA |
| Zip Code | 01107-1108 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Jonathan L Bayuk | 354 Birnie Ave, Springfield, MA 01107-1108 | Controlled Substance Registration for Practitioner | 2012-12-05 ~ 2015-02-28 |
| Shannon B Widderick Pa | 354 Birnie Ave, Springfield, MA 01107-1108 | Controlled Substance Registration for Practitioner | 2011-03-01 ~ 2013-02-28 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Brittany Chew | 354 Birnie Ave Fl 1, Springfield, MA 01107-1108 | Registered Nurse | 2020-04-01 ~ 2021-03-31 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Lauren Elizabeth Marshall | 945 Armory St, Springfield, MA 01107 | Physician Assistant | 2020-04-01 ~ 2021-03-31 |
| Jennifer L Fish | 367 Union Street, Springfield, MA 01107 | Hairdresser/cosmetician | ~ |
| Joseph Pagan | 59 Rowland Street, Springfield, MA 01107 | Medication Administration Certification | 2020-04-20 ~ 2022-04-19 |
| Daniel Laguerre | 382 Springfield St, Springfield, MA 01107 | Crane Operator | ~ |
| Kamal Kant Kalia | 2 Medical Center Drive, Springfield, MA 01107 | Physician/surgeon | 2020-03-01 ~ 2021-02-28 |
| Bushee Enterprises LLC | Po Box 1196, Southwick, MA 01107 | Home Improvement Contractor | 2015-12-01 ~ 2016-11-30 |
| B Lopez | 165 Prospect Street, Springfield, MA 01107 | Notary Public Appointment | 2011-10-01 ~ 2016-09-30 |
| Beth C Mcinerny | 260 Ware Road, Belchertown, MA 01107 | Registered Nurse | 2019-12-01 ~ 2020-11-30 |
| Jorge Enrique Rivera | 20 Narragansett Street, Springfield, MA 01107 | Professional Counselor | 2019-10-01 ~ 2020-09-30 |
| Rachael Hynds-decoteau | 22 Candice Cir, Springfield, MA 01107 | Controlled Substance Registration for Practitioner | 2019-09-19 ~ 2021-02-28 |
| Find all Licenses in zip 01107 | |||
| City | SPRINGFIELD |
| Zip Code | 01107 |
| License Type | Physician/Surgeon |
| License Type + County | Physician/Surgeon + SPRINGFIELD |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| David A. Ditsworth | 920 S Robertson Blvd, Los Angeles, CA 90035-1602 | Physician/surgeon | ~ 1977-12-31 |
| Russell W Robertson | Po Box 234, Dublin, NH 03444-0234 | Physician/surgeon | 2012-12-01 ~ 2013-11-30 |
| Lauri R Robertson Md | 254 Bradley St, New Haven, CT 06510 | Physician/surgeon | 2007-01-23 ~ 2008-03-31 |
| Gonzalo M Saravi | 20 Robertson Lane, Cos Cob, CT 06807 | Physician/surgeon | 2001-08-22 ~ 2002-09-30 |
| Kenneth L Justice | 2261 Robertson View Pt, Sevierville, TN 37876 | Physician/surgeon | 2008-10-20 ~ 2009-04-30 |
| Douglas J Robertson | 5114 Copper Ridge Rd, Durham, NC 27707 | Physician/surgeon | 1995-09-12 ~ 1996-11-30 |
| Manolisa T Cornel-manaloto | 11848 Robertson Farm Circle, Fairfax, VA 22030 | Physician/surgeon | 2020-01-01 ~ 2020-12-31 |
| Laura J Robertson | 2309 Shaded Brook Drive, Owings Mills, MD 21117 | Physician/surgeon | 2007-10-22 ~ 2008-09-30 |
| Bryan Robertson · Robertson Contracting | 23 Todd Road, Katonah, NY 10536 | New Home Construction Contractor | 2007-10-01 ~ 2009-09-30 |
| Robertson Winery Wolfkloof Shiraz Robertson | Connecticut Brand Registration, Hartford, CT 06106 | Liquor Brand Label | 2013-02-27 ~ 2016-02-26 |
Please comment or provide details below to improve the information on DAVID M. ROBERTSON.
| 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).