JUSTIN LEE (Credential# 1133267) is licensed (Physician/surgeon) with Connecticut Department of Consumer Protection. The license effective date is May 1, 2019. The license expiration date date is April 30, 2020. The license status is ACTIVE.
JUSTIN LEE is licensed with the Department of Consumer Protection of Connecticut. The credential number is #1.051528. The credential type is physician/surgeon. The effective date is May 1, 2019. The expiration date is April 30, 2020. The business address is 1100 Stark Drive, Mt Vernon, IL 62864. The current status is active.
| Licensee Name | JUSTIN LEE |
| Credential ID | 1133267 |
| Credential Number | 1.051528 |
| Credential Type | Physician/Surgeon |
| Business Address |
1100 Stark Drive Mt Vernon IL 62864 |
| Business Type | INDIVIDUAL |
| Status | ACTIVE - CURRENT |
| Active | 1 |
| Issue Date | 2012-12-14 |
| Effective Date | 2019-05-01 |
| Expiration Date | 2020-04-30 |
| Refresh Date | 2019-05-13 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 1157524 | CSP.0054494 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 2013-04-09 | 2015-03-01 - 2017-02-28 | INACTIVE |
| 894751 | CSP.0046533 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 2009-09-16 | 2009-09-16 - 2011-02-28 | INACTIVE |
| Street Address | 1100 Stark Drive |
| City | Mt Vernon |
| State | IL |
| Zip Code | 62864 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Clifford R Fields | 123 S 10th St Ste 400, Mt Vernon, IL 62864 | Architect | 1996-08-01 ~ 1997-07-31 |
| Lormed LLC | 3307 Broadway St Ste 150, Mount Vernon, IL 62864-2387 | Wholesaler of Drugs, Cosmetics & Medical Devices | 2014-07-01 ~ 2015-01-05 |
| Walgreen Co | 5100 Lake Ter Ne, Mount Vernon, IL 62864-9665 | Wholesaler of Drugs, Cosmetics & Medical Devices | 2020-07-01 ~ 2021-06-30 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Royal Caribbean Bakery | 620 South Fulton Ave, Mt Vernon, NY 10550 | Bakery | 2020-07-01 ~ 2021-06-30 |
| Claudia M Spencer | 180 Pearsall Dr#1e, Mt Vernon, NY 10552 | Registered Nurse | 2020-09-01 ~ 2021-08-31 |
| Maxine A Augustus-powell · Augustus | 417 South 9th Avenue, Mt Vernon, NY 10550 | Registered Nurse | 2020-06-01 ~ 2021-05-31 |
| Nadia Antoine-williams | 395 Gramatan Ave, Mt Vernon, NY 10552 | Registered Nurse - Temporary | 2020-04-14 ~ 2020-08-12 |
| Margaret A Robinson · Campbell | P.o. Box 265, Mt Vernon, NY 10551 | Registered Nurse | 2020-02-01 ~ 2021-01-31 |
| Eldorine F Manning | 58 Parkway South, Mt Vernon, NY 10552 | Licensed Practical Nurse | 2020-04-01 ~ 2021-03-31 |
| Martin P Bragdon | 982 North Rd, Mt Vernon, ME 04352 | Professional Engineer | 2020-02-01 ~ 2021-01-31 |
| Angelo Ignomirello | 126 Park Avenue, Mt Vernon, NY 10550 | Notary Public Appointment | 2012-03-01 ~ 2017-02-28 |
| Margaret Malagiero | 24 Elmsmere Road, Mt Vernon, NY 10552 | Notary Public Appointment | 1997-07-30 ~ 2002-07-31 |
| Jonchel Prioleau | 409 Nuber Avenue, Mt Vernon, NY 10553 | Notary Public Appointment | 1998-12-07 ~ 2003-12-31 |
| Find all Licenses in Mt Vernon | |||
| City | Mt Vernon |
| Zip Code | 62864 |
| License Type | Physician/Surgeon |
| License Type + County | Physician/Surgeon + Mt Vernon |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Justin J De Grado | Psc 475 Box 1812, Fpo, 96350 | Physician/surgeon | 2014-06-01 ~ 2015-05-31 |
| Justin Marshall | 200 Retreat Ave, Hartford, CT 06106-3309 | Physician/surgeon | 2020-07-01 ~ 2021-06-30 |
| Justin J Finch | 1 Willowbrook Rd, Cromwell, CT 06416-1745 | Physician/surgeon | 2020-03-01 ~ 2021-02-28 |
| Justin Cashman | 821 Chesapeake Ave, Annapolis, MD 21403-3249 | Physician/surgeon | 2014-08-15 ~ 2015-07-31 |
| Justin G Ford | 210 19th Ave A, Seattle, WA 98122 | Physician/surgeon | 2014-08-01 ~ 2015-07-31 |
| Justin C Cahill Md | 267 Grant Street, Bridgeport, CT 06610 | Physician/surgeon | 2020-06-01 ~ 2021-05-31 |
| Justin Harold | 8025 W Lorraine Pl, Milwaukee, WI 53222-4933 | Physician/surgeon | 2020-03-04 ~ 2021-03-31 |
| Justin D Radolf | 23 Sarah Drive, Avon, CT 06001 | Physician/surgeon | 2019-09-01 ~ 2020-08-31 |
| Justin C Paul | 2 Riverview Drive, Danbury, CT 06851 | Physician/surgeon | 2020-07-01 ~ 2021-06-30 |
| Justin B Lundbye Md | 64 Robbins Street, Waterbury, CT 06708 | Physician/surgeon | 2020-04-01 ~ 2021-03-31 |
Please comment or provide details below to improve the information on JUSTIN LEE.
| 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).