DOUGLAS W. KINGMA (Credential# 1186001) is licensed (Physician/surgeon) with Connecticut Department of Consumer Protection. The license effective date is October 1, 2019. The license expiration date date is September 30, 2020. The license status is ACTIVE.
DOUGLAS W. KINGMA is licensed with the Department of Consumer Protection of Connecticut. The credential number is #1.052541. The credential type is physician/surgeon. The effective date is October 1, 2019. The expiration date is September 30, 2020. The business address is 5441 Edmondson Pike, Nashville, TN 37211. The current status is active.
| Licensee Name | DOUGLAS W. KINGMA |
| Credential ID | 1186001 |
| Credential Number | 1.052541 |
| Credential Type | Physician/Surgeon |
| Business Address |
5441 Edmondson Pike Nashville TN 37211 |
| Business Type | INDIVIDUAL |
| Status | ACTIVE - CURRENT |
| Active | 1 |
| Issue Date | 2013-10-28 |
| Effective Date | 2019-10-01 |
| Expiration Date | 2020-09-30 |
| Refresh Date | 2019-09-26 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 996709 | 1 | Physician/Surgeon | - | EXPIRED APPLICATION |
| Street Address | 5441 Edmondson Pike |
| City | Nashville |
| State | TN |
| Zip Code | 37211 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Asurion Compassion Fund | 648 Grassmere Park Drive, No. 300, Nashville, TN 37211 | Public Charity | 2020-06-24 ~ 2021-11-30 |
| Monteagle Funds | 2506 Winford Avenue, Nashville, TN 37211 | Investment Company - Open End | 2019-12-31 ~ 2020-12-31 |
| Brandy Abruzzo | 2305 Kline Ave, Nashville, TN 37211 | Interior Designer | 2020-01-01 ~ 2020-12-31 |
| Andrew A Baummer | 305 Mccall Street, Nashville, TN 37211 | Professional Engineer | 2020-02-01 ~ 2021-01-31 |
| Prasad Subbanna | 116 Honey Creek Lane, Nashville, TN 37211 | Engineer-in-training | 1988-01-12 ~ 1998-01-12 |
| Clinical Solutions LLC | 601 Grassmere Park Drive Ste #14, Nashville, TN 37211 | Nonresident Pharmacy | 2014-09-01 ~ 2015-08-31 |
| Jill D Propper | 4808 Overcrest Drive, Nashville, 37211 | Massage Therapist | 2014-01-29 ~ 2016-01-06 |
| Michael P Flynn | 6775 Holt Rd, Nashville, TN 37211 | Professional Engineer | 1990-06-13 ~ 1991-01-31 |
| Edward B Hudgens | 1441 Wexford Downs Lane, Nashville, TN 37211 | Professional Engineer | 2013-02-01 ~ 2014-01-31 |
| Nancy C Parker | 201 Cedarcreek Drive, Nashville, TN 37211 | Registered Nurse | 2012-04-01 ~ 2013-03-31 |
| Find all Licenses in zip 37211 | |||
| City | Nashville |
| Zip Code | 37211 |
| License Type | Physician/Surgeon |
| License Type + County | Physician/Surgeon + Nashville |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Douglas R. Mailly | 119 Russell St, Cornwall, NY 12518-1711 | Physician/surgeon | ~ |
| Douglas A Rofrano Md | 279 Oakville Ave Apt 9a, Waterbury, CT 06708 | Physician/surgeon | 2005-09-26 ~ 2006-06-30 |
| Douglas B Bober | 603 Countryside Pl Se, Smyrna, GA 30080-8238 | Physician/surgeon | 2011-09-01 ~ 2012-08-31 |
| Douglas J Van Der Heide | 7 East 85 St, New York, NY 10028 | Physician/surgeon | 2011-12-01 ~ 2012-11-30 |
| Douglas M Brandt | 407 Evenwillow Way, Aiken, SC 29803-1769 | Physician/surgeon | 2020-03-01 ~ 2021-02-28 |
| Douglas R Whipple Md | 30 Wildwood Dr, Avon, CT 06001 | Physician/surgeon | 2020-03-01 ~ 2021-02-28 |
| Gregory P Geba Md | 5 Douglas Dr, Sparta, NJ 07871 | Physician/surgeon | 2020-01-01 ~ 2020-12-31 |
| Douglas J Roberts Jr | 56 Four Mile Riv Rd, Old Lyme, CT 06371-1542 | Physician/surgeon | 2008-07-14 ~ 2009-07-31 |
| Douglas A Ballan | 145 Connetquot Dr, Oakdale, NY 11769-1902 | Physician/surgeon | 2017-01-01 ~ 2017-12-31 |
| Herbert J Douglas | 490 Riverside Dr, Cheshire, CT 06410 | Physician/surgeon | 1988-06-23 ~ 1989-05-31 |
Please comment or provide details below to improve the information on DOUGLAS W. KINGMA.
| 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).