EEJUNG KIM (Credential# 1633038) is licensed (Resident Physician) with Connecticut Department of Consumer Protection. The license effective date is July 1, 2019. The license expiration date date is June 30, 2021. The license status is ACTIVE.
EEJUNG KIM is licensed with the Department of Consumer Protection of Connecticut. The credential number is #1.062368-RES. The credential type is resident physician. The effective date is July 1, 2019. The expiration date is June 30, 2021. The business address is 3648 Hyde Park Ave Unit 1, Cincinnati, OH 45208-1407. The current status is active.
Licensee Name | EEJUNG KIM |
Credential ID | 1633038 |
Credential Number | 1.062368-RES |
Credential Type | Resident Physician |
Credential SubCategory | RES |
Business Address |
3648 Hyde Park Ave Unit 1 Cincinnati OH 45208-1407 |
Business Type | INDIVIDUAL |
Status | ACTIVE - CURRENT |
Active | 1 |
Issue Date | 2019-07-01 |
Effective Date | 2019-07-01 |
Expiration Date | 2021-06-30 |
Refresh Date | 2020-05-27 |
ID | Credential Code | Credential Type | Issue | Term | Status |
---|---|---|---|---|---|
1628798 | CSP.0070176 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 2019-02-19 | 2019-02-19 - 2021-02-28 | ACTIVE |
Street Address | 3648 HYDE PARK AVE UNIT 1 |
City | CINCINNATI |
State | OH |
Zip Code | 45208-1407 |
Licensee Name | Office Address | Credential | Effective / Expiration |
---|---|---|---|
Alisa Kanfi | 1151 Halpin Ave, Cincinnati, OH 45208 | Physician/surgeon | 2014-01-01 ~ 2014-12-31 |
Richard A. Hobson | 2877 Alpine Terrace, Cincinnati, OH 45208 | Certified Public Accountant Certificate | ~ |
Jennifer M Thumm | 3434 Burch Ave., Cincinnati, OH 45208 | Certified Public Accountant License | 2000-01-01 ~ 2000-12-31 |
Gail Marie Donovan | 2552 Madison Rd Apt 22, Cincinnati, OH 45208-1145 | Registered Nurse | 1983-11-01 ~ 1984-10-31 |
Vincent D Mortimer | 2874 Victoria Ave, Cincinnati, OH 45208-1431 | Professional Engineer | 2010-02-02 ~ 2011-01-31 |
Marnie E Sullivan | 2542 Erie Ave Apt P309, Cincinnati, OH 45208-2020 | Occupational Therapist | 1999-06-14 ~ 2001-07-31 |
Hyde Park Gourmet Food & Wine Inc | 2703 Erie Ave, Cincinnati, OH 45208-2103 | Out of State Retailer Shipper for Wine | 2019-11-05 ~ 2020-11-04 |
Biowish Technologies Inc | 2724 Erie Ave Ste C, Cincinnati, OH 45208-2125 | Commercial Feed | 2019-01-01 ~ 2019-12-31 |
Wise Organics | 2724 Erie Ave Ste B, Cincinnati, OH 45208-2125 | Commercial Fertilizer | 2014-07-01 ~ 2015-06-30 |
Kristin M Rayball | 3302 Eastside Ave, Cincinnati, OH 45208-2712 | Chiropractor | 2015-12-01 ~ 2016-11-30 |
Find all Licenses in zip 45208 |
City | CINCINNATI |
Zip Code | 45208 |
License Type | Resident Physician |
License Type + County | Resident Physician + CINCINNATI |
Licensee Name | Office Address | Credential | Effective / Expiration |
---|---|---|---|
Yan Zhu | 27 Brainerd Rd # B, Branford, CT 06405-6302 | Resident Physician | 2020-07-01 ~ 2021-06-30 |
Jennifer A Guy | 6 Early Dr Apt K, Watervliet, NY 12189-2517 | Resident Physician | ~ |
Jin Woo Yoo | 44 Orange St Apt 317, New Haven, CT 06510 | Resident Physician | 2020-07-01 ~ 2021-06-30 |
Gin Yi Lee | 24 Hospital Ave, Danbury, CT 06810-6099 | Resident Physician | 2019-06-20 ~ 2022-06-30 |
Victoria Parker | CT | Resident Physician | 2015-06-23 ~ 2021-06-30 |
Jia Wei Tan | 267 Grant St, Bridgeport, CT 06610-2805 | Resident Physician | 2020-06-22 ~ 2023-06-30 |
Tao Zuo | 20 York St., New Haven, CT 06510-3220 | Resident Physician | 2016-07-25 ~ 2020-06-30 |
Hongjie Li | 20 York St, New Haven, CT 06510 | Resident Physician | 2019-07-26 ~ 2021-06-30 |
Gino J Mongelluzzo | 213 W 3rd St, Bloomsburg, PA 17815 | Resident Physician | 2015-06-25 ~ 2019-06-30 |
Sue-ting Lim | 56 Franklin St, Waterbury, CT 06706-1253 | Resident Physician | 2019-07-01 ~ 2024-06-30 |
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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).