MARK A INNIS (Credential# 1630631) is licensed (Physician/surgeon) with Connecticut Department of Consumer Protection. The license effective date is October 2, 2019. The license expiration date date is August 31, 2020. The license status is ACTIVE.
MARK A INNIS is licensed with the Department of Consumer Protection of Connecticut. The credential number is #1.064363. The credential type is physician/surgeon. The effective date is October 2, 2019. The expiration date is August 31, 2020. The business address is 3636 High Street, Portsmoth, VA 23707. The current status is active.
| Licensee Name | MARK A INNIS |
| Credential ID | 1630631 |
| Credential Number | 1.064363 |
| Credential Type | Physician/Surgeon |
| Business Address |
3636 High Street Portsmoth VA 23707 |
| Business Type | INDIVIDUAL |
| Status | ACTIVE - CURRENT |
| Active | 1 |
| Issue Date | 2019-10-02 |
| Effective Date | 2019-10-02 |
| Expiration Date | 2020-08-31 |
| Refresh Date | 2019-10-03 |
| Street Address | 3636 High Street |
| City | Portsmoth |
| State | VA |
| Zip Code | 23707 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Linda B Tucker | 120 Gilmerton Ave, Portsmouth, VA 23707 | Licensed Practical Nurse | 2007-07-02 ~ 2008-06-30 |
| Alexander Berger | 210 Monitor Rd, Portsmouth, VA 23707-1020 | Physician/surgeon | 1958-08-25 ~ 1989-05-31 |
| Mutts With A Mission | 3122 High St, Portsmouth, VA 23707-3427 | Public Charity | 2019-12-02 ~ 2020-11-30 |
| Barbara A Outland | 113 Howard St Apt 302, Portsmouth, VA 23707-4757 | Licensed Practical Nurse | 2019-10-01 ~ 2020-09-30 |
| City | Portsmoth |
| Zip Code | 23707 |
| License Type | Physician/Surgeon |
| License Type + County | Physician/Surgeon + Portsmoth |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Nelson A Bonheim | 12 Innis Ln, Old Greenwich, CT 06870-1706 | Physician/surgeon | 2018-09-01 ~ 2019-08-31 |
| Robert Innis Md | Va Medical Ctr 116a2, West Haven, CT 06516 | Physician/surgeon | 2001-04-19 ~ 2002-06-30 |
| William Innis · Innis Designs In Wood | 207 Westbrook Rd, Essex, CT 06426 | Home Improvement Contractor | 2005-09-15 ~ 2005-11-30 |
| Innis Arden Golf | 120 Tomac Ave, Old Greenwich, CT 06870-1818 | Non Profit Club Liquor | 2020-02-23 ~ 2021-06-22 |
| Mark M Silverstein | Mark Silverstein,md, Manchester, NJ 08759 | Physician/surgeon | 2020-02-01 ~ 2021-01-31 |
| Innis Designs In Wood LLC | 207 Westbrook Rd, Essex, CT 06426 | Home Improvement Contractor | 2010-12-01 ~ 2011-11-30 |
| Mark Davis | Po Box 222, Abingdon, MD 21009-0222 | Physician/surgeon | ~ |
| Ron Mark | 6 Annette Way, Jericho, NY 11753 | Physician/surgeon | 2019-09-01 ~ 2020-08-31 |
| Mark L Friedman | Po Box 298, Newbury, NH 03255-0298 | Physician/surgeon | 2020-03-01 ~ 2021-02-28 |
| Mark Levin | 6 Gel Ct, Monsey, NY 10952-1956 | Physician/surgeon | 2020-06-01 ~ 2021-05-31 |
Please comment or provide details below to improve the information on MARK A INNIS.
| 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).