HYUN JU NAM (Credential# 1653220) 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, 2022. The license status is ACTIVE.
HYUN JU NAM is licensed with the Department of Consumer Protection of Connecticut. The credential number is #1.062863-RES. The credential type is resident physician. The effective date is July 1, 2019. The expiration date is June 30, 2022. The business address is 263 Farmington Avenue, Farmington, CT 06030-1921. The current status is active.
| Licensee Name | HYUN JU NAM |
| Credential ID | 1653220 |
| Credential Number | 1.062863-RES |
| Credential Type | Resident Physician |
| Credential SubCategory | RES |
| Business Address |
263 Farmington Avenue Farmington CT 06030-1921 |
| Business Type | INDIVIDUAL |
| Status | ACTIVE - CURRENT |
| Active | 1 |
| Issue Date | 2019-07-01 |
| Effective Date | 2019-07-01 |
| Expiration Date | 2022-06-30 |
| Refresh Date | 2019-05-01 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 1654136 | CSP.0070775 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 2019-06-18 | 2019-06-18 - 2021-02-28 | ACTIVE |
| Street Address | 263 Farmington Avenue |
| City | Farmington |
| State | CT |
| Zip Code | 06030-1921 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Davis Aasen | 263 Farmington Avenue, Farmington, CT 06030-1921 | Resident Physician | 2020-07-01 ~ 2025-06-30 |
| Christopher D Lemoine | 263 Farmington Avenue, Farmington, CT 06030-1921 | Resident Physician | 2020-07-01 ~ 2025-06-30 |
| Dylan Buller | 263 Farmington Avenue, Farmington, CT 06030-1921 | Resident Physician | 2020-07-01 ~ 2025-06-30 |
| Jennifer Lindelof | 263 Farmington Avenue, Farmington, CT 06030-1921 | Resident Physician | 2020-07-01 ~ 2025-06-30 |
| Colin J Pavano | 263 Farmington Avenue, Farmington, CT 06030-1921 | Resident Physician | 2020-07-01 ~ 2025-06-30 |
| Barrett B Torre | 263 Farmington Avenue, Farmington, CT 06030-1921 | Resident Physician | 2020-07-01 ~ 2025-06-30 |
| Samantha Slattery | 263 Farmington Avenue, Farmington, CT 06030-1921 | Resident Physician | 2020-07-01 ~ 2025-06-30 |
| Ethan A Miller | 263 Farmington Avenue, Farmington, CT 06030-1921 | Resident Physician | 2020-06-28 ~ 2024-06-30 |
| Patrick Bergamo | 263 Farmington Avenue, Farmington, CT 06030-1921 | Resident Physician | 2020-06-28 ~ 2024-06-30 |
| Shriya Gupta | 263 Farmington Avenue, Farmington, CT 06030-1921 | Resident Physician | 2020-06-28 ~ 2024-06-30 |
| Find all Licenses in the same address | |||
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Hady Eltayeby | 263 Farmington Avenue, Ct, Farmington, CT 06030-1921 | Controlled Substance Registration for Practitioner | ~ |
| Hassaan Aftab | 263 Farmington Ave, Farmington, CT 06030-1921 | Resident Physician | 2019-07-01 ~ 2021-06-30 |
| Adriana Kahn | 263 Farmington Ave, Farmington, CT 06030-1921 | Resident Physician | 2018-06-28 ~ 2021-06-30 |
| Shinya U. Amano | 263 Farmington Ave, Farmington, CT 06030-1921 | Resident Physician | 2019-05-23 ~ 2019-06-06 |
| Mathur Prateek | 263 Farmington Ave, Farmington, CT 06030-1921 | Resident Physician | 2019-01-02 ~ 2019-01-24 |
| Kenneth Aguirre | 263 Farmington Ave, Farmington, CT 06030-1921 | Resident Physician | 2018-11-08 ~ 2018-11-17 |
| Nick M Feo | 263 Farmington Ave, Farmington, CT 06030-1921 | Resident Physician | 2018-10-01 ~ 2018-10-14 |
| Rabeea Nazir | 263 Farmington Ave, Farmington, CT 06030-1921 | Resident Physician | 2018-09-30 ~ 2018-10-13 |
| Jacob Jabbour | 263 Farmington Ave, Farmington, CT 06030-1921 | Resident Physician | 2018-09-17 ~ 2018-09-28 |
| Natalie Godfrey | 263 Farmington Ave, Farmington, CT 06030-1921 | Resident Physician | 2018-08-13 ~ 2018-08-24 |
| Find all Licenses in zip 06030-1921 | |||
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Eric Anthony Brueckner | 263 Farmington Ave., Farmington, CT 06030 | Physician/surgeon | 2020-08-01 ~ 2021-07-31 |
| Derrick B Bremang | Residency Program, Farmington, CT 06030 | Physician/surgeon | 2020-06-01 ~ 2021-06-30 |
| David M Shafer | Uconn Health Center, Farmington, CT 06030 | Dentist | 2020-07-01 ~ 2021-06-30 |
| Michael J Murphy | Dept of Dermatology, Farmington, CT 06030 | Physician/surgeon | 2020-09-01 ~ 2021-08-31 |
| Richard F Kaplan | Univ. of Ct., Farmington, CT 06030 | Psychologist | 2020-06-01 ~ 2021-05-31 |
| Nicholas George Vitale | 22 Woods Drive, Norwich, CT 06030 | Casino Class I Employee | 2019-12-03 ~ 2020-10-31 |
| Bruce E Gould | Univ of Conn Health Center, Farmington, CT 06030 | Physician/surgeon | 2020-04-01 ~ 2021-03-31 |
| Vinayak M Sathe | Uconn Health Center,263 Farmington Ave, Farmington, CT 06030 | Physician/surgeon | 2020-06-01 ~ 2021-05-31 |
| Shobhana Pathani | Department of Medicine, 263 Farmington Ave, CT 06030 | Physician/surgeon | 2020-06-01 ~ 2021-05-31 |
| Patricia L Almeida | John Dempsey Hospital, Farmington, CT 06030 | Registered Nurse | 2020-04-01 ~ 2021-03-31 |
| Find all Licenses in zip 06030 | |||
| City | Farmington |
| Zip Code | 06030 |
| License Type | Resident Physician |
| License Type + County | Resident Physician + Farmington |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Hyun Hee Kim | 230 S Frontage Rd, New Haven, CT 06519-1124 | Resident Physician | 2019-07-01 ~ 2021-06-30 |
| Emily Hyun | 300 George St Ste 901, New Haven, CT 06511-6662 | Resident Physician | 2018-06-11 ~ 2022-06-30 |
| Clifford Hyun Min Shin | 20 York St Rm 226, New Haven, CT 06510-3220 | Resident Physician | 2020-07-01 ~ 2021-06-30 |
| Eric Sung Hyun Chu | 263 Farmington Ave, Farmington, CT 06030-0001 | Resident Physician | 2019-07-01 ~ 2022-06-30 |
| Soo Hyun Kae | 263 Farmington Avenue, Farmington, CT 06030-1921 | Resident Physician | 2019-06-28 ~ 2022-06-30 |
| Sung Hyun Lee · Sung Hyun Lee | 43-44 160 Street, 1st Floor, Flushing, NY 11358 | Hairdresser/cosmetician | 2006-01-11 ~ 2008-02-29 |
| Hyun-joon Lee | 47 Oak St Ste 250, Stamford, CT 06905-5320 | Physician/surgeon | 2019-09-01 ~ 2020-08-31 |
| Hyun Ju Jane Im | 282 Washington St, Hartford, CT 06106 | Physician/surgeon | 2020-05-01 ~ 2021-04-30 |
| Chang Hyun Michael Choi | 7879 Silverlake Ln, Memphis, TN 38119 | Physician/surgeon | 2020-02-01 ~ 2021-01-31 |
| Hyun Suk Lee Md | 99 East River Dr, 5th Fl, East Hartford, CT 06108-7301 | Physician/surgeon | 2020-03-01 ~ 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).