AMY LEIGH STARK
Physician/surgeon


Address: 171 Grandeville Rd Sw, Rochester, MN 55902-2485

AMY LEIGH STARK (Credential# 1404101) is licensed (Physician/surgeon) with Connecticut Department of Consumer Protection. The license effective date is April 1, 2018. The license expiration date date is March 31, 2019. The license status is INACTIVE.

Business Overview

AMY LEIGH STARK is licensed with the Department of Consumer Protection of Connecticut. The credential number is #1.056306. The credential type is physician/surgeon. The effective date is April 1, 2018. The expiration date is March 31, 2019. The business address is 171 Grandeville Rd Sw, Rochester, MN 55902-2485. The current status is inactive.

Basic Information

Licensee Name AMY LEIGH STARK
Credential ID 1404101
Credential Number 1.056306
Credential Type Physician/Surgeon
Business Address 171 Grandeville Rd Sw
Rochester
MN 55902-2485
Business Type INDIVIDUAL
Status INACTIVE - LAPSED DUE TO NON-RENEWAL
Issue Date 2017-03-29
Effective Date 2018-04-01
Expiration Date 2019-03-31
Refresh Date 2019-07-04

Other licenses

ID Credential Code Credential Type Issue Term Status
1415125 CSP.0065114 CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER 2017-03-31 2017-03-31 - 2019-02-28 LAPSED

Office Location

Street Address 171 GRANDEVILLE RD SW
City ROCHESTER
State MN
Zip Code 55902-2485

Licenses in the same zip code

Licensee Name Office Address Credential Effective / Expiration
Eunsook Samantha Lee 910 Wicklow Lane Sw, Rochester, MN 55902 Pharmacist 2018-02-01 ~ 2020-01-31
Pradeep K Siddappa 620 2nd St Sw 311, Rochester, MN 55902 Controlled Substance Registration for Practitioner 2019-03-01 ~ 2021-02-28
Joshua L Shones 635 36th St Sw, Rochester, MN 55902 Professional Engineer 2017-02-01 ~ 2018-01-31
Hildon House Usa 1421 20th St S W, Rochester, MN 55902 Non-alcoholic Beverage & Water Bottlers 1997-06-10 ~ 1998-06-30
Manuel A Moreno Gonzales 159 Grandeville Road Sw Vnh22, Rochester, MN 55902 Controlled Substance Registration for Practitioner 2016-06-29 ~ 2017-02-28
Eileen F Hawkins 844 7th Ave Sw, Rochester, MN 55902 Registered Nurse 1993-05-25 ~ 1994-07-31
Kenneth A Iczkowski 621 1st St S.w., Rochester, MN 55902 Physician/surgeon ~ 1996-07-31
Craig A Hawkins 844 7th Avenue Sw, Rochester, MN 55902 Physician/surgeon 1994-02-25 ~ 1995-01-31
Heilia L Vines 2804 2nd Street Sw, Rochester, MN 55902 Registered Nurse 2007-01-08 ~ 2008-01-31
Lynette J Krakowski 2845 Fox Valley Dr, Rochester, MN 55902 Registered Nurse 1994-06-16 ~ 1995-06-30
Find all Licenses in zip 55902

Competitor

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City ROCHESTER
Zip Code 55902
License Type Physician/Surgeon
License Type + County Physician/Surgeon + ROCHESTER

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Leigh S Bergmann 919 Conestoga Road, Rosemont, PA 19010 Physician/surgeon 2006-12-18 ~ 2007-10-31
Diana Leigh Rowell 375 Farmington Ave, New Britain, CT 06053-2356 Physician/surgeon 1991-05-31 ~ 1992-04-30
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Dataset Information

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).

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