MINGJUN SONG (Credential# 1413942) 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 INACTIVE.
MINGJUN SONG is licensed with the Department of Consumer Protection of Connecticut. The credential number is #CSP.0065078. 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 5 Perryridge Road, Greenwich, CT 06830. The current status is inactive.
| Licensee Name | MINGJUN SONG |
| Credential ID | 1413942 |
| Credential Number | CSP.0065078 |
| Credential Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| Business Address |
5 Perryridge Road Greenwich CT 06830 |
| Business Type | INDIVIDUAL |
| Status | INACTIVE - LACK OF ACTIVE MEDICAL LICENSE |
| Issue Date | 2017-04-11 |
| Effective Date | 2019-03-01 |
| Expiration Date | 2021-02-28 |
| Refresh Date | 2020-04-24 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 1487707 | 1.057394-RES | Resident Physician | 2016-06-27 | 2016-06-27 - 2020-02-25 | INACTIVE |
| Street Address | 5 Perryridge Road |
| City | Greenwich |
| State | CT |
| Zip Code | 06830 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Deepa Jansen | 5 Perryridge Road, Greenwich, CT 06830 | Resident Physician | 2019-06-24 ~ 2022-06-27 |
| Ginamarie Papia | 5 Perryridge Road, Greenwich, CT 06830 | Resident Physician | 2019-06-24 ~ 2022-06-27 |
| Ju Young Bae | 5 Perryridge Road, Greenwich, CT 06830 | Resident Physician | 2019-06-24 ~ 2022-06-27 |
| Michael Foti | 5 Perryridge Road, Greenwich, CT 06830 | Resident Physician | 2019-06-24 ~ 2022-06-27 |
| Waqas Salam | 5 Perryridge Road, Greenwich, CT 06830 | Resident Physician | 2019-06-24 ~ 2022-06-27 |
| Romelle J Maloney | 5 Perryridge Road, Greenwich, CT 06830 | Physician/surgeon | 2020-07-01 ~ 2021-06-30 |
| Kristin T Hsieh | 5 Perryridge Road, Greenwich, CT 06830 | Resident Physician | 2020-06-22 ~ 2021-06-28 |
| Fatema S Esaa | 5 Perryridge Road, Greenwich, CT 06830 | Resident Physician | 2020-06-22 ~ 2021-06-28 |
| Eunjin Park | 5 Perryridge Road, Greenwich, CT 06831 | Physician Assistant | 2020-06-01 ~ 2021-05-31 |
| Jeremy B Barowsky | 5 Perryridge Road, Greenwich, CT 06830 | Physician/surgeon | 2020-06-01 ~ 2021-05-31 |
| Find all Licenses in the same address | |||
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Junior League of Greenwich Conn Inc. | 231 East Putnam Ave., Greenwich, CT 06830 | Public Charity | 2019-06-01 ~ 2020-05-31 |
| Michelle Yoo | 35 Putnam Green, Greenwich, CT 06830 | Combination Nail Technician, Esthetician Or Eyelash Technici | 2020-06-27 ~ 2022-01-31 |
| Michele S Bergen | Greenwich Medical Building, Greenwich, CT 06830 | Physician/surgeon | 2020-07-01 ~ 2021-06-30 |
| Black Forest Pastry | 52 Lewis Street, Greenwich, CT 06830 | Bakery | 2020-07-01 ~ 2021-06-30 |
| Maurasaca Pallchisaca Gloria Veronica | 103 Greenwich Ave, Greenwich, CT 06830 | Combination Nail Technician, Esthetician Or Eyelash Technici | ~ |
| Deborah B Huffard | 107 Maple Ave, Greenwich, CT 06830 | Real Estate Salesperson | 2020-06-01 ~ 2021-05-31 |
| Joann H Alexander | 157 Stanwich Road, Greenwich, CT 06830 | Real Estate Salesperson | 2020-06-01 ~ 2021-05-31 |
| Dandan Tu | 24 Byfield Ln, Greenwich, CT 06830 | Physician/surgeon | 2020-06-01 ~ 2021-05-31 |
| Mohamed Akli Zetchi | 2 Perryridge Road, Greenwich, CT 06830 | Physician/surgeon | 2020-08-01 ~ 2021-07-31 |
| Gateway Classical Music Society Inc | 292 Stanwich Road, Greenwich, CT 06830 | Public Charity | 2020-12-01 ~ 2021-11-30 |
| Find all Licenses in zip 06830 | |||
| City | Greenwich |
| Zip Code | 06830 |
| License Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| License Type + County | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER + Greenwich |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Mingjun Wang Od | 293 Turnpike Road #504, Westborough, MA 01581 | Controlled Substance Registration for Practitioner | 2002-03-01 ~ 2003-02-28 |
| Jin Song | 141-09 28th Ave, 2b, Flushing, NY 11354 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Christopher Song | 365 Montauk Ave, New London, CT 06320 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Jae W Song | 360 State St Apt 2403, New Haven, CT 06510-3623 | Controlled Substance Registration for Practitioner | ~ |
| Kigon Song Dds | 9 Elderslie Ln, Woodbridge, CT 06525-1038 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Walter Song | Marb 4th Flr, Farmington, CT 06030 | Controlled Substance Registration for Practitioner | 2007-03-01 ~ 2008-02-29 |
| Eunice S Song | 82 Brittany Farms Rd Apt 233, New Britain, CT 06053-1246 | Controlled Substance Registration for Practitioner | 2017-03-01 ~ 2019-02-28 |
| Jenny Song Aprn | 950 Farmington Ave Apt C 20, New Britain, CT 06053 | Controlled Substance Registration for Practitioner | 2009-03-01 ~ 2011-02-28 |
| Shuhua Song | 1 Bay Club Drive, Bayside, NY 11360 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Seung Yub Song | 26 Belden Ave Unit 2128, Norwalk, CT 06850-3384 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
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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).