SPENCER N CHURCH (Credential# 1516697) is licensed (Resident Physician) with Connecticut Department of Consumer Protection. The license effective date is July 1, 2020. The license expiration date date is June 30, 2021. The license status is ACTIVE.
SPENCER N CHURCH is licensed with the Department of Consumer Protection of Connecticut. The credential number is #1.060938-RES. The credential type is resident physician. The effective date is July 1, 2020. The expiration date is June 30, 2021. The business address is 20 Hunting Ridge Farms Rd, Branford, CT 06405-6129. The current status is active.
| Licensee Name | SPENCER N CHURCH |
| Credential ID | 1516697 |
| Credential Number | 1.060938-RES |
| Credential Type | Resident Physician |
| Credential SubCategory | RES |
| Business Address |
20 Hunting Ridge Farms Rd Branford CT 06405-6129 |
| Business Type | INDIVIDUAL |
| Status | ACTIVE - CURRENT |
| Active | 1 |
| Issue Date | 2018-06-13 |
| Effective Date | 2020-07-01 |
| Expiration Date | 2021-06-30 |
| Refresh Date | 2020-06-04 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 850538 | 70.010805 | Emergency Medical Technician | 2009-06-15 | 2010-10-21 - 2014-04-01 | INACTIVE |
| Street Address | 20 HUNTING RIDGE FARMS RD |
| City | BRANFORD |
| State | CT |
| Zip Code | 06405-6129 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Spencer Church | 20 Hunting Ridge Farms Rd, Branford, CT 06405-6129 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Jeff E Theis | 21 Hunting Ridge Farms Rd, Branford, CT 06405-6129 | Dentist | 2020-04-01 ~ 2021-03-31 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Raymond M Johnson | 39 Bayberry Lane, Branford, CT 06405 | Physician/surgeon | 2020-07-01 ~ 2021-06-30 |
| Kirsten M Ranciato | 288 East Main Street, Branford, CT 06405 | Licensed Clinical Social Worker | 2020-08-01 ~ 2021-07-31 |
| Bimala Khadka Thapa | 726 Robert Frost Dr., Branford, CT 06405 | Nail Technician | ~ |
| Paul E Basile | 42 Valley Brook Road South, Branford, CT 06405 | Perfusionist | 2020-08-01 ~ 2021-07-31 |
| Lupe Monica Placencia-muy | 100 East Main Street 2nd Fl, Branford, CT 06405 | Combination Nail Technician, Esthetician Or Eyelash Technici | 2020-06-27 ~ 2022-02-28 |
| Bridget J Jennings | 159 Queach Road, Branford, CT 06405 | Registered Nurse | 2020-09-01 ~ 2021-08-31 |
| Ujeli Acharya | 21 Burban Drive, Branford, CT 06405 | Nail Technician | ~ |
| Cathleen Smith | 50 First Avenue, Branford, CT 06405 | Radiographer | 2020-07-01 ~ 2021-06-30 |
| Gita Thapa | 94 Village Lane, Branford, CT 06405 | Nail Technician | ~ |
| Cycle Venture Partners Fund I Lp - Lumeda Series 1 | 50 Limewood Avenue, Branford, CT 06405 | Securities - Exemptions | 2020-06-17 ~ |
| Find all Licenses in zip 06405 | |||
| City | BRANFORD |
| Zip Code | 06405 |
| License Type | Resident Physician |
| License Type + County | Resident Physician + BRANFORD |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Spencer Beck | 35 Shire Ct, Cheshire, CT 06410-3556 | Resident Physician | 2020-06-24 ~ 2021-06-30 |
| Noah A Capurso | 227 Church St Apt 3h, New Haven, CT 06510-1826 | Resident Physician | 2015-07-02 ~ 2021-06-30 |
| Sara Smolinski | 205 Church St Apt 7l, New Haven, CT 06510-1884 | Resident Physician | 2016-06-26 ~ 2019-06-30 |
| Fathima F Reyman | 227 Church St., New Haven, CT 06510 | Resident Physician | 2014-07-01 ~ 2021-06-30 |
| Michael Vincent Gormally | 205 Church St, New Haven, CT 06510-1805 | Resident Physician | 2020-07-01 ~ 2021-06-30 |
| Jason A Chin | 109 Church Street #223, New Haven, CT 06510 | Resident Physician | 2017-07-01 ~ 2018-06-30 |
| Holly Blackburn | 205 Church Street, New Haven, CT 06510 | Resident Physician | 2020-07-01 ~ 2021-06-30 |
| Simona Tsipan-esposito | 109 Church St Unit 222, New Haven, CT 06510-3025 | Resident Physician | 2020-07-01 ~ 2021-06-30 |
| Idaira Aguilar Tejedor | 109 Church St Unit 606, New Haven, CT 06510-3012 | Resident Physician | 2019-07-01 ~ 2021-06-30 |
| Nina Phillips Bernstein | 109 Church St Unit 606, New Haven, CT 06510-3012 | Resident Physician | 2014-06-27 ~ 2020-06-30 |
Please comment or provide details below to improve the information on SPENCER N CHURCH.
| 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).