KEITH B QUENCER (Credential# 1220510) is licensed (Physician/surgeon) with Connecticut Department of Consumer Protection. The license effective date is November 1, 2017. The license expiration date date is October 31, 2018. The license status is INACTIVE.
KEITH B QUENCER is licensed with the Department of Consumer Protection of Connecticut. The credential number is #1.053203. The credential type is physician/surgeon. The effective date is November 1, 2017. The expiration date is October 31, 2018. The business address is 198 Edwards St Apt 4, New Haven, CT 06511-3702. The current status is inactive.
| Licensee Name | KEITH B QUENCER |
| Credential ID | 1220510 |
| Credential Number | 1.053203 |
| Credential Type | Physician/Surgeon |
| Business Address |
198 Edwards St Apt 4 New Haven CT 06511-3702 |
| Business Type | INDIVIDUAL |
| Status | INACTIVE - LAPSED DUE TO NON-RENEWAL |
| Issue Date | 2014-06-25 |
| Effective Date | 2017-11-01 |
| Expiration Date | 2018-10-31 |
| Refresh Date | 2019-02-03 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 1170802 | CSP.0055025 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 2013-07-08 | 2015-03-01 - 2017-02-28 | INACTIVE |
| Street Address | 198 EDWARDS ST APT 4 |
| City | NEW HAVEN |
| State | CT |
| Zip Code | 06511-3702 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Rachel Ng | 198 Edwards St Apt 4, New Haven, CT 06511-3702 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Claire S Kaufman | 198 Edwards St Apt 4, New Haven, CT 06511-3702 | Controlled Substance Registration for Practitioner | 2015-03-01 ~ 2017-02-28 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Susan Maya | 198 Edwards St Apt 3, New Haven, CT 06511-3702 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Heather S Dobbin Pa | 198 Edwards St Apt 6, New Haven, CT 06511-3702 | Controlled Substance Registration for Practitioner | 2013-03-01 ~ 2015-02-28 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Montessori School On Edgewood Inc. | 230 Edgewood Avenue, New Haven, CT 06511 | Public Charity | 2019-06-01 ~ 2020-05-31 |
| Therese Parks · Visel Drug Store | 264 Munson St, New Haven, CT 06511 | Registered Nurse | 2020-07-01 ~ 2021-06-30 |
| Dazjia Monet Green | 115 Edgewood Ave Apt 64, New Haven, CT 06511 | Registered Nurse | 2020-06-27 ~ 2021-05-31 |
| Carol Yam | 343 Humphrey St, New Haven, CT 06511 | Registered Nurse | ~ |
| Marwan S Haddad | 38 Lincoln Street, New Haven, CT 06511 | Physician/surgeon | 2020-07-01 ~ 2021-06-30 |
| Mary Lou Gaeta Md | 558 Chapel Street, New Haven, CT 06511 | Physician/surgeon | 2020-07-01 ~ 2021-06-30 |
| Cary M Tucker | 64 Bishop St, New Haven, CT 06511 | Architect | 2020-08-01 ~ 2021-07-31 |
| Frank J Pannenborg | 505 Ellsworth Ave, New Haven, CT 06511 | Architect | 2020-08-01 ~ 2021-07-31 |
| Crystal E Gooding | 26 Woodland Street, New Haven, CT 06511 | Notary Public Appointment | 2020-07-01 ~ 2025-06-30 |
| Kieran Jones | 260 Crown St Unit 1f, New Haven, CT 06511 | Registered Nurse | ~ |
| Find all Licenses in zip 06511 | |||
| City | NEW HAVEN |
| Zip Code | 06511 |
| License Type | Physician/Surgeon |
| License Type + County | Physician/Surgeon + NEW HAVEN |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Keith C Boldon Md | Keith Boldon Md, Cheshire, CT 06410 | Physician/surgeon | 2020-03-01 ~ 2021-02-28 |
| Keith Gallagher | 11 Bishop St, New Haven, CT 06511-3931 | Physician/surgeon | 2020-04-01 ~ 2021-03-31 |
| Keith A Vom Eigen | 37 Hobson Ave, Windsor, CT 06095 | Physician/surgeon | 2020-01-01 ~ 2020-12-31 |
| Keith A Hernandez Md | 193 River Rd, Madison, CT 06443 | Physician/surgeon | 2020-06-01 ~ 2021-05-31 |
| Keith J Champney | 17 Ewell Ave, Lexington, MA 02421 | Physician/surgeon | 1999-10-14 ~ 2000-08-31 |
| Keith M Spellman | Po Box 320757, Los Gatos, CA 95032-0112 | Physician/surgeon | 2018-09-01 ~ 2019-08-31 |
| Keith A Kaplan | 24 Carriage Dr, Farmington, CT 06032-2704 | Physician/surgeon | 2020-04-01 ~ 2021-03-31 |
| Keith Edwards | 140 Hospital Dr, Bennington, VT 05201 | Physician/surgeon | 1992-07-23 ~ 1993-06-30 |
| Keith Ray Hodge Md | 95 Dover Rd, W Hartford, CT 06119 | Physician/surgeon | 2001-03-12 ~ 2002-03-31 |
| Keith A Cauley | 33 Fairview Dr, Farmington, CT 06032-2516 | Physician/surgeon | 2020-01-24 ~ 2020-08-31 |
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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).