KELLY L VANDERHAVE (Credential# 1629735) is licensed (Physician/surgeon) 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.
KELLY L VANDERHAVE is licensed with the Department of Consumer Protection of Connecticut. The credential number is #1.062970. The credential type is physician/surgeon. The effective date is July 1, 2020. The expiration date is June 30, 2021. The business address is 1518 Sterling Rd, Charlotte, NC 28209-1546. The current status is active.
| Licensee Name | KELLY L VANDERHAVE |
| Credential ID | 1629735 |
| Credential Number | 1.062970 |
| Credential Type | Physician/Surgeon |
| Business Address |
1518 Sterling Rd Charlotte NC 28209-1546 |
| Business Type | INDIVIDUAL |
| Status | ACTIVE - CURRENT |
| Active | 1 |
| Issue Date | 2019-05-08 |
| Effective Date | 2020-07-01 |
| Expiration Date | 2021-06-30 |
| Refresh Date | 2020-04-18 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 1655242 | CSP.0070868 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 2019-05-09 | 2019-05-09 - 2021-02-28 | ACTIVE |
| Street Address | 1518 STERLING RD |
| City | CHARLOTTE |
| State | NC |
| Zip Code | 28209-1546 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Heather Dawn Carlson | 4438 Universitydrive, Charlotte, NC 28209 | Registered Nurse - Temporary | 2020-02-21 ~ 2020-06-20 |
| Tammy C Stanard | 1322 E Woodlawn Road, Charlotte, NC 28209 | Real Estate Salesperson | 2020-06-01 ~ 2021-05-31 |
| Barbra A Beck | 2829 Dorchester Place, Charlotte, NC 28209 | Registered Nurse | 2020-05-01 ~ 2021-04-30 |
| Dixon Hughes Goodman LLP | 4350 Congress Street, Suite 900, Charlotte, NC 28209 | Certified Public Accountant Firm Permit | 2020-01-01 ~ 2020-12-31 |
| Laura Ann Adams | 2736 Lawndale Rd., Charlotte, NC 28209 | Veterinarian | 2019-07-18 ~ 2020-07-31 |
| Kathleen A Canty | 100 Matador Lane, #301, Charlotte, NC 28209 | Certified Public Accountant License | 1991-03-16 ~ 1991-12-31 |
| Terry E Dalton | Dmr Architecture, Charlotte, NC 28209 | Architect | 2001-08-01 ~ 2002-07-31 |
| Kristina M Grasso | 2720 D, Charlotte, NC 28209 | Licensed Clinical Social Worker | 2000-12-28 ~ 2002-02-28 |
| Stacey Reid | 3903 South Blvd, Charlotte, NC 28209 | Physical Therapist | 1999-04-23 ~ 2000-04-30 |
| David E Kelly | 1711 Montford Dr, Charlotte, NC 28209 | Dentist | 1999-04-20 ~ 2000-06-30 |
| Find all Licenses in zip 28209 | |||
| City | CHARLOTTE |
| Zip Code | 28209 |
| License Type | Physician/Surgeon |
| License Type + County | Physician/Surgeon + CHARLOTTE |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Sherry L Lee | 24 Kelly Dr, Marlton, NJ 08053-9701 | Physician/surgeon | 2017-07-25 ~ 2018-04-30 |
| Michael J Kelly | Po Box 585, Salisbury, CT 06068-0585 | Physician/surgeon | 2019-09-01 ~ 2020-08-31 |
| Kelly Benabou | 267 Grant St, Bridgeport, CT 06610-2805 | Physician/surgeon | ~ |
| George P Kelly | 113 Sky Top Drive, Fairfield, CT 06825 | Physician/surgeon | 2020-06-01 ~ 2021-05-31 |
| Michael Kelly Md | 84 Bishop St, New Haven, CT 06511 | Physician/surgeon | 2007-09-10 ~ 2008-07-31 |
| Kelly Olino | 330 Cedar St, New Haven, CT 06510-3218 | Physician/surgeon | 2020-04-01 ~ 2021-03-31 |
| Kelly A Flynn Md | 114 Woodland St, Hartford, CT 06105-1208 | Physician/surgeon | 2020-07-01 ~ 2021-06-30 |
| Kelly Maureen Dillman | 342 E 110th St Apt 5d, New York, NY 10029-7088 | Physician/surgeon | ~ |
| Donald R Kelly | 387 Indies Dr, Orchid, FL 32963-9559 | Physician/surgeon | 2019-08-01 ~ 2020-07-31 |
| Jeremy A. Spiegel | 14 Kelly Rd, Falmouth, ME 04105-2107 | Physician/surgeon | 2012-09-24 ~ 2013-08-31 |
Please comment or provide details below to improve the information on KELLY L VANDERHAVE.
| 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).