ROY K KIBERENGE (Credential# 1361673) is licensed (Controlled Substance Registration for Practitioner) with Connecticut Department of Consumer Protection. The license effective date is March 1, 2019. The license expiration date date is February 28, 2021. The license status is ACTIVE.
ROY K KIBERENGE is licensed with the Department of Consumer Protection of Connecticut. The credential number is #CSP.0063214. The credential type is controlled substance registration for practitioner. The effective date is March 1, 2019. The expiration date is February 28, 2021. The business address is 3445 1st Ave S, Minneapolis, MN 55408-4506. The current status is active.
| Licensee Name | ROY K KIBERENGE |
| Credential ID | 1361673 |
| Credential Number | CSP.0063214 |
| Credential Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| Business Address |
3445 1st Ave S Minneapolis MN 55408-4506 |
| Business Type | INDIVIDUAL |
| Status | ACTIVE - CURRENT |
| Active | 1 |
| Issue Date | 2016-08-04 |
| Effective Date | 2019-03-01 |
| Expiration Date | 2021-02-28 |
| Refresh Date | 2019-02-26 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 1340819 | 1.055554 | Physician/Surgeon | 2016-07-27 | 2019-11-01 - 2020-11-30 | ACTIVE |
| 1490784 | 1.058886-RES | Resident Physician | 2016-09-01 | 2016-09-01 - 2018-06-30 | INACTIVE |
| Street Address | 3445 1ST AVE S |
| City | MINNEAPOLIS |
| State | MN |
| Zip Code | 55408-4506 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Mark H Bradby | 3335 Hennepin Ave, Minneapolis, MN 55408 | Professional Engineer | 2019-02-01 ~ 2020-01-31 |
| Amanda Kathryn Ross | 1200 Lagoon Ave, Minneapolis, MN 55408 | Physician Assistant | 2018-09-01 ~ 2019-08-31 |
| Melvin Lee Urlacher · Anderson-urlacher Pa | 3516 Colfax Ave S, Minneapolis, MN 55408 | Professional Engineer | 2004-02-01 ~ 2005-01-31 |
| Julie A Bauch | 3536 Holmes Ave S, Minneapolis, MN 55408 | Registered Nurse | 2010-07-01 ~ 2011-06-30 |
| David G Ondich | 3137 Emerson Ave So, Minneapolis, MN 55408 | Physician/surgeon | 1993-03-24 ~ 1994-02-28 |
| Alexander K Ledbetter | 3513 Dupont Ave. S. #108, Minneapolis, MN 55408 | Speech and Language Pathologist | 2003-03-13 ~ 2004-01-31 |
| Anders G Wisnewski | 1456 Lagoon Ave South #106, Minneapolis, MN 55408 | Landscape Architect | 2001-08-03 ~ 2002-07-31 |
| Ali P Shahrian | 2935 S. Fremont Ave, Minneaplis, MN 55408 | Controlled Substance Registration for Practitioner | 2006-10-10 ~ 2007-02-28 |
| Re Power | 2639 Nicollet Ave Ste 220, Minneapolis, MN 55408-1629 | Public Charity | 2019-12-01 ~ 2020-11-30 |
| Re Power Fund | 2639 Nicollet Ave Ste 220, Minneapolis, MN 55408-1629 | Public Charity | 2019-12-01 ~ 2020-11-30 |
| Find all Licenses in zip 55408 | |||
| City | MINNEAPOLIS |
| Zip Code | 55408 |
| License Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| License Type + County | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER + MINNEAPOLIS |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Steven Kassels Md · Community Substance Abuse Center | Comm. Physicians PC/125 North Elm Street, Westfield, MA 01085 | Controlled Substance Registration for Practitioner | 2018-06-15 ~ 2019-02-28 |
| Shu-i Lin | CT | Controlled Substance Registration for Practitioner | 2017-06-12 ~ 2019-02-28 |
| Arundati Rao | CT | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Hae J Kim Pa | New Haven, CT 06511 | Controlled Substance Registration for Practitioner | 2008-03-31 ~ 2009-02-28 |
| Qi Che Md | Bridgeport, CT 06610 | Controlled Substance Registration for Practitioner | 2006-03-01 ~ 2007-02-28 |
| Huu Duc D Luu | 630 Mix Ave Apt 6p, Hamden, CT 06514-2320 | Controlled Substance Registration for Practitioner | 2011-03-01 ~ 2013-02-28 |
| Erin K Fee | CT | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Min Jin Kim | 639 4th Ave Apt 5c, Brooklyn, NY 11232-1048 | Controlled Substance Registration for Practitioner | 2012-05-10 ~ 2013-02-28 |
| Rachel Lin | 6b Orchard St, Cos Cob, CT 06807-2407 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Yat Tse Md | 174 Hillspoint Rd, Westport, CT 06880 | Controlled Substance Registration for Practitioner | 1994-11-02 ~ 1996-11-01 |
Please comment or provide details below to improve the information on ROY K KIBERENGE.
| 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).