MATTHEW S CLARK (Credential# 1214496) is licensed (Physician/surgeon) with Connecticut Department of Consumer Protection. The license effective date is December 1, 2019. The license expiration date date is November 30, 2020. The license status is ACTIVE.
MATTHEW S CLARK is licensed with the Department of Consumer Protection of Connecticut. The credential number is #1.053638. The credential type is physician/surgeon. The effective date is December 1, 2019. The expiration date is November 30, 2020. The business address is Po Box 129, Montrose, NY 10548-0129. The current status is active.
Licensee Name | MATTHEW S CLARK |
Credential ID | 1214496 |
Credential Number | 1.053638 |
Credential Type | Physician/Surgeon |
Business Address |
Po Box 129 Montrose NY 10548-0129 |
Business Type | INDIVIDUAL |
Status | ACTIVE - CURRENT |
Active | 1 |
Issue Date | 2014-11-04 |
Effective Date | 2019-12-01 |
Expiration Date | 2020-11-30 |
Refresh Date | 2019-09-09 |
ID | Credential Code | Credential Type | Issue | Term | Status |
---|---|---|---|---|---|
1183409 | 2.011099 | Dentist | 2013-11-26 | 2019-12-01 - 2020-11-30 | ACTIVE |
1220476 | 22.008477 | Dental Anesthesia/Conscious Sedation Permit | 2014-09-19 | 2019-10-01 - 2020-09-30 | ACTIVE |
1214927 | CSP.0056945 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 2014-04-09 | 2017-03-01 - 2019-02-28 | LAPSED |
Street Address | PO Box 129 |
City | Montrose |
State | NY |
Zip Code | 10548-0129 |
Licensee Name | Office Address | Credential | Effective / Expiration |
---|---|---|---|
Donald F Izzo | 6 Marisa Court, Montrose, NY 10548 | Paramedic | 2020-07-01 ~ 2021-06-30 |
Leana Marie Travis | 103 Coachlight Square, Montrose, NY 10548 | Registered Nurse | 2020-03-01 ~ 2021-02-28 |
Christine F Crimmins | 64 Montrose Point Rd., Montrose, NY 10548 | Registered Nurse | 2019-12-01 ~ 2020-11-30 |
Donna U Baker | 3 Crystal Court, Montrose, NY 10548 | Notary Public Appointment | 2005-11-21 ~ 2010-11-30 |
Marie Curtis | 265 Coachlight Square, Montrose, NY 10548 | Notary Public Appointment | 2000-07-18 ~ 2005-07-31 |
Judy Coppola | 269 Coachlight Square, Montrose, NY 10548 | Notary Public Appointment | 2005-02-23 ~ 2010-02-28 |
James W Booth IIi · Car Keys Express | 37 Kings Ferry Rd, Montrose, NY 10548 | Locksmith | 2019-08-27 ~ 2020-12-31 |
Nicole S Mordin | 12 Harper Ave, Montrose, NY 10548 | Registered Nurse | 2019-08-01 ~ 2020-07-31 |
Merrill L Roth | 9 Travis Lane, Montrose, NY 10548 | Real Estate Broker | 2018-04-01 ~ 2019-03-31 |
John Dwyer · Dwyer Woodworking | 1 Dutch St, Montrose, NY 10548 | Home Improvement Contractor | 2008-12-01 ~ 2009-11-30 |
Find all Licenses in zip 10548 |
City | Montrose |
Zip Code | 10548 |
License Type | Physician/Surgeon |
License Type + County | Physician/Surgeon + Montrose |
Licensee Name | Office Address | Credential | Effective / Expiration |
---|---|---|---|
R S Briggs Md | 138 Clark Rd, Litchfield, CT 06759 | Physician/surgeon | 2006-12-21 ~ 2007-12-31 |
Ann O Massion Md | 157 Clark St, Worcester, MA 01606 | Physician/surgeon | 2002-04-16 ~ 2003-05-31 |
Michael K Mccloud Md | 2 Clark Dr #322, San Mateo, CA 94401 | Physician/surgeon | 1998-12-28 ~ 2000-02-29 |
Marie Bellantoni | 140 Clark St, Milford, CT 06460 | Physician/surgeon | 1994-04-28 ~ 1995-03-31 |
Todd A Silberstein Do | 198 Clark Ave, Branford, CT 06405 | Physician/surgeon | 2006-12-28 ~ 2007-12-31 |
Brian J Clark | 1 Caleb Ct, Guilford, CT 06437-2298 | Physician/surgeon | 2020-07-01 ~ 2021-06-30 |
Clark E O'brien | P.o. Box 722, West Simsbury, CT 06092 | Physician/surgeon | 2018-11-01 ~ 2019-10-31 |
Denise Clark | 1 North Ln, Albany, NY 12211-1629 | Physician/surgeon | 2020-08-01 ~ 2021-07-31 |
Harvey E Armel | 140 Clark St, Milford, CT 06460-3221 | Physician/surgeon | 2020-03-01 ~ 2021-02-28 |
Antonio Scappaticci Md | 625 Clark Ave, Bristol, CT 06010 | Physician/surgeon | 2020-09-01 ~ 2021-08-31 |
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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).