LISA KIM (Credential# 1278090) is licensed (Controlled Substance Registration for Practitioner) with Connecticut Department of Consumer Protection. The license effective date is April 23, 2015. The license expiration date date is February 28, 2017. The license status is INACTIVE.
LISA KIM is licensed with the Department of Consumer Protection of Connecticut. The credential number is #CSP.0059844. The credential type is controlled substance registration for practitioner. The effective date is April 23, 2015. The expiration date is February 28, 2017. The business address is 56 Franklin St, Waterbury, CT 06706-1253. The current status is inactive.
| Licensee Name | LISA KIM |
| Credential ID | 1278090 |
| Credential Number | CSP.0059844 |
| Credential Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| Business Address |
56 Franklin St Waterbury CT 06706-1253 |
| Business Type | INDIVIDUAL |
| Status | INACTIVE |
| Issue Date | 2015-04-23 |
| Effective Date | 2015-04-23 |
| Expiration Date | 2017-02-28 |
| Refresh Date | 2018-01-29 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Lisa Kim | 155-17 Sanford Ave. #4e, Flushing, NY 11355 | Combination Nail Technician, Esthetician Or Eyelash Technici | ~ |
| Street Address | 56 FRANKLIN ST |
| City | WATERBURY |
| State | CT |
| Zip Code | 06706-1253 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Benjamin Dahlberg | 56 Franklin St, Waterbury, CT 06706-1253 | Resident Physician | 2020-07-01 ~ 2026-06-30 |
| Vikram Bhatt | 56 Franklin St, Waterbury, CT 06706-1253 | Resident Physician | 2019-07-01 ~ 2026-06-30 |
| Sue-ting Lim | 56 Franklin St, Waterbury, CT 06706-1253 | Resident Physician | 2019-07-01 ~ 2024-06-30 |
| Suraj J Panjwani | 56 Franklin St, Waterbury, CT 06706-1253 | Resident Physician | 2019-07-01 ~ 2024-06-30 |
| Samir Dengle | 56 Franklin St, Waterbury, CT 06706-1253 | Resident Physician | 2020-07-01 ~ 2023-06-30 |
| Diego A Accorsi | 56 Franklin St, Waterbury, CT 06706-1253 | Resident Physician | 2019-07-01 ~ 2023-06-30 |
| Santosh Swaminathan | 56 Franklin St, Waterbury, CT 06706-1253 | Resident Physician | 2019-07-01 ~ 2023-06-30 |
| Saman Tariq | 56 Franklin St, Waterbury, CT 06706-1253 | Resident Physician | 2020-06-10 ~ 2023-06-20 |
| Michelle Yeung | 56 Franklin St, Waterbury, CT 06706-1253 | Resident Physician | 2020-06-15 ~ 2023-06-20 |
| Bhavya Vemuri | 56 Franklin St, Waterbury, CT 06706-1253 | Resident Physician | 2020-06-15 ~ 2023-06-20 |
| Find all Licenses in the same address | |||
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Kaitlyn Jennings | Saint Mary's Emergency Department, Waterbury, CT 06706-1253 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Vitas Healthcare Corporation Atlantic Inpatient Unit | 56 Franklin St Fl 4, Waterbury, CT 06706-1253 | Hospice | 2019-04-01 ~ 2021-03-31 |
| Julia Zefirova | Department of Medicine, Waterbury, CT 06706-1253 | Physician/surgeon | 2018-12-01 ~ 2019-11-30 |
| William A Fabricius | Department of Medicine, Waterbury, CT 06706-1253 | Controlled Substance Registration for Practitioner | 2013-03-01 ~ 2015-02-28 |
| Felipe V Orozco | Department of Medicine, Waterbury, CT 06706-1253 | Controlled Substance Registration for Practitioner | 2011-03-01 ~ 2013-02-28 |
| Evgeny Kirsanov | Department of Medicine, Waterbury, CT 06706-1253 | Controlled Substance Registration for Practitioner | 2011-03-01 ~ 2013-02-28 |
| Vinay Singh | Department of Medicine, Waterbury, CT 06706-1253 | Controlled Substance Registration for Practitioner | 2011-03-01 ~ 2013-02-28 |
| M A Sohail | Department of Medicine, Waterbury, CT 06706-1253 | Controlled Substance Registration for Practitioner | 2011-03-01 ~ 2013-02-28 |
| Mugen Liu | Department of Medicine, Waterbury, CT 06706-1253 | Controlled Substance Registration for Practitioner | 2009-03-05 ~ 2011-02-28 |
| Pingali C Mohan | Department of Medicine, Waterbury, CT 06706-1253 | Controlled Substance Registration for Practitioner | 2009-03-01 ~ 2011-02-28 |
| Find all Licenses in zip 06706-1253 | |||
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Yiajaira Morales | 424 Baldwin St., Waterbury, CT 06706 | Medication Administration Certification | 2020-05-01 ~ 2022-04-30 |
| Timiki M White | 921 Hamilton Avenue Unit 6, Waterbury, CT 06706 | Notary Public Appointment | 2020-06-01 ~ 2025-05-31 |
| Lymarie Torres Garcia | 107 Alpine Ave., Waterbury, CT 06706 | Licensed Practical Nurse | 2020-09-01 ~ 2021-08-31 |
| Ann M Iannantuoni | 456 Prospect Rd, Waterbury, CT 06706 | Registered Nurse | 2020-07-01 ~ 2021-06-30 |
| Brittany Morgan | 921 Hamilton Ave., Waterbury, CT 06706 | Medication Administration Certification | 2018-04-14 ~ 2020-04-13 |
| Chevelle Hinton | 35 Mountain Village Rd Unit 2, Waterbury, CT 06706 | Medication Administration Certification | 2020-05-19 ~ 2022-05-18 |
| Juan A Bano | 685 Summer St, Waterbury, CT 06706 | Asbestos Abatement Worker | ~ |
| Esther Campos Dasilva | 31 Benjamin St, Waterbury, CT 06706 | Emergency Medical Responder | ~ |
| Rebecca L Diblasi | 295 Edgewood Avenue, Waterbury, CT 06706 | Real Estate Salesperson | 2020-06-11 ~ 2021-05-31 |
| Rnz Services LLC | 76 Lounsbury Ave Apt 2, Waterbury, CT 06706 | Home Improvement Contractor | 2020-06-12 ~ 2020-11-30 |
| Find all Licenses in zip 06706 | |||
| City | WATERBURY |
| Zip Code | 06706 |
| License Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| License Type + County | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER + WATERBURY |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Lisa Phuong | 440 W End Ave Apt 12f, New York, NY 10024-5358 | Controlled Substance Registration for Practitioner | 2017-03-01 ~ 2019-02-28 |
| Lisa K Yoo Do | 121 Gower Rd, New Canaan, CT 06840 | Controlled Substance Registration for Practitioner | 2017-03-01 ~ 2019-02-28 |
| Lisa D Picascia | Middletown, CT 06457 | Controlled Substance Registration for Practitioner | 2018-04-04 ~ 2019-02-28 |
| Lisa M Fox | 50 Woodland Dr, Northford, CT 06472-1206 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Lisa J Mao | 49 Lake Ave, Greenwich, CT 06830-4501 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Lisa M Decarlo | 36 Peck St, Norwich, CT 06360-5515 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Lisa J Uri Md | 219 Saddle Hill Rd, Stamford, CT 06903 | Controlled Substance Registration for Practitioner | 2006-03-01 ~ 2007-02-28 |
| Lisa Mh Dries Do | 90 Ludlow Rd, Windsor, CT 06095 | Controlled Substance Registration for Practitioner | 2008-03-19 ~ 2009-02-28 |
| Lisa Goebel Pa | 528 Cypress Rd, Newington, CT 06111 | Controlled Substance Registration for Practitioner | 1997-03-01 ~ 1998-02-28 |
| Lisa E Fogel Md | 69 Sand Pit Rd Ste 101, Danbury, CT 06810 | Controlled Substance Registration for Practitioner | 2006-03-01 ~ 2007-02-28 |
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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).