KIMBERLY CAROL IRWIN (Credential# 1802539) is licensed (Physician/surgeon) with Connecticut Department of Consumer Protection. The license effective date is May 1, 2020. The license expiration date date is April 30, 2021. The license status is ACTIVE.
KIMBERLY CAROL IRWIN is licensed with the Department of Consumer Protection of Connecticut. The credential number is #1.064589. The credential type is physician/surgeon. The effective date is May 1, 2020. The expiration date is April 30, 2021. The business address is 124 Berkshire Cir, Bridgeport, WV 26330-9108. The current status is active.
| Licensee Name | KIMBERLY CAROL IRWIN |
| Credential ID | 1802539 |
| Credential Number | 1.064589 |
| Credential Type | Physician/Surgeon |
| Business Address |
124 Berkshire Cir Bridgeport WV 26330-9108 |
| Business Type | INDIVIDUAL |
| Status | ACTIVE - CURRENT |
| Active | 1 |
| Issue Date | 2019-11-15 |
| Effective Date | 2020-05-01 |
| Expiration Date | 2021-04-30 |
| Refresh Date | 2020-03-11 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 1806784 | CSP.0072786 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 2019-11-18 | 2019-11-18 - 2021-02-28 | ACTIVE |
| Street Address | 124 BERKSHIRE CIR |
| City | BRIDGEPORT |
| State | WV |
| Zip Code | 26330-9108 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Paula Anne Martin | 232 Blackwell Street, Bridgeport, WV 26330 | Registered Nurse - Temporary | 2017-08-10 ~ 2017-12-07 |
| Symbol Technologies Inc | 109 Platinum Dr, Bridgeport, WV 26330 | Major Contractor | ~ |
| Katilyn Romain | 82 Elk Ridge Rd, Bridgeport, WV 26330-6713 | Occupational Therapist | 2019-10-01 ~ 2021-07-31 |
| Emily L Knudsen | 194 Maple Lk, Bridgeport, WV 26330-9591 | Emergency Medical Technician | 2006-06-20 ~ 2008-04-01 |
| Deborah L Bragg | 887 Rr 2, Bridgeport, WV 26330-9760 | Registered Nurse | 2011-11-01 ~ 2012-10-31 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Bridgeport Rescue Mission Inc | Po Box 9057, Bridgeport, CT 06601-9057 | Public Charity | 2019-06-01 ~ 2020-05-31 |
| Jeannette Roman | 60 Gilmore St Apt 23, Bridgeport, CT 06608-2620 | Registered Nurse | 2020-07-01 ~ 2021-06-30 |
| Gbapp Inc | 1470 Barnum Ave Ste 301, Bridgeport, CT 06610-3237 | Public Charity | 2019-07-31 ~ 2020-05-31 |
| Julia Lopez | 147 Rocton Ave, Bridgeport, CT 06606 | Nail Technician | ~ |
| Sarah F Cunningham | 120 Higgins Ave, Bridgeport, CT 06606-3718 | Licensed Practical Nurse | 2020-07-01 ~ 2021-06-30 |
| Gloriana C Tardie | 270 Central Ave, Bridgeport, CT 06607-2497 | Public Weigher | 2020-07-01 ~ 2021-06-30 |
| Famous Pizza | 430 Park Avenue, Bridgeport, CT 06604 | Bakery | 2020-07-01 ~ 2021-06-30 |
| Shakia Johanna Willis | 340 Saunders Ave, Bridgeport, CT 06606-3930 | Registered Nurse | 2020-06-27 ~ 2021-05-31 |
| Elizabeth Kristine Lopez | 207 Kensington Pl, Bridgeport, CT 06610-1147 | Registered Nurse | 2020-06-27 ~ 2021-01-31 |
| Sonia M Lozada | 207 Jackson Avenue, Bridgeport, CT 06606 | Notary Public Appointment | 2020-09-01 ~ 2025-08-31 |
| Find all Licenses in BRIDGEPORT | |||
| City | BRIDGEPORT |
| Zip Code | 26330 |
| License Type | Physician/Surgeon |
| License Type + County | Physician/Surgeon + BRIDGEPORT |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Carol L Dorfman | 81 Kimberly Dr, Guilford, CT 06437-1314 | Physician/surgeon | 2020-04-01 ~ 2021-03-31 |
| Irwin Martin Reich | 600 3rd Ave Fl 2, New York, NY 10016-1919 | Physician/surgeon | 2019-12-18 ~ 2020-10-31 |
| Irwin M Greenberg | 4 Surrey Lane, Waquoit, MA 02536-3467 | Physician/surgeon | 1997-12-30 ~ 1998-09-30 |
| Irwin T Mancall | 10 Golf Rd, West Hartford, CT 06117 | Physician/surgeon | 2008-02-26 ~ 2009-03-31 |
| Irwin Nash | 1450 Chapel St, New Haven, CT 06511 | Physician/surgeon | 2020-02-01 ~ 2021-01-31 |
| Sowdhamani Bellapu | 3246 Irwin Ave, Bronx, NY 10463-3705 | Physician/surgeon | 2020-03-02 ~ 2021-03-31 |
| John B Irwin | 21 Sarcka Lane, Litchfield, CT 06759 | Physician/surgeon | 2012-12-01 ~ 2013-11-30 |
| Irwin Gelman Md | Silver Hill Hospital, New Canaan, CT 06840 | Physician/surgeon | 2020-07-01 ~ 2021-06-30 |
| Irwin R Maier | 11995 Singletree Ln Ste 500, Eden Prairie, MN 55344-5349 | Physician/surgeon | 2017-03-30 ~ 2017-06-30 |
| Leonard Irwin Eisenfeld Md | 126 Clifton Ave, West Hartford, CT 06107 | Physician/surgeon | 2020-07-01 ~ 2021-06-30 |
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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).