CHARLES A GUNDERSEN (Credential# 540168) is licensed (Physician/surgeon) with Connecticut Department of Consumer Protection. The license effective date is January 1, 2019. The license expiration date date is December 31, 2019. The license status is INACTIVE.
CHARLES A GUNDERSEN is licensed with the Department of Consumer Protection of Connecticut. The credential number is #1.011896. The credential type is physician/surgeon. The effective date is January 1, 2019. The expiration date is December 31, 2019. The business address is 5 White Birch Bend, Portland, CT 06480. The current status is inactive.
| Licensee Name | CHARLES A GUNDERSEN |
| Credential ID | 540168 |
| Credential Number | 1.011896 |
| Credential Type | Physician/Surgeon |
| Business Address |
5 White Birch Bend Portland CT 06480 |
| Business Type | INDIVIDUAL |
| Status | INACTIVE - LAPSED DUE TO NON-RENEWAL |
| Issue Date | 1964-09-21 |
| Effective Date | 2019-01-01 |
| Expiration Date | 2019-12-31 |
| Refresh Date | 2020-06-08 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 150440 | CSP.0005217 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 1999-03-01 | 2017-03-01 - 2019-02-28 | LAPSED |
| Street Address | 5 WHITE BIRCH BEND |
| City | PORTLAND |
| State | CT |
| Zip Code | 06480 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Galladex Bd T85% I 9082 | 47 Lower Main St, Portland, CT 06480 | Medical Marijuana Producer Brand Registration | 2020-06-26 ~ |
| Suzanne S O'rourke | 35 Apple Tree Lane, Portland, CT 06480 | Notary Public Appointment | 2020-09-01 ~ 2025-08-31 |
| Gui Jiang | Sunny�s Nail&spa, Portland, CT 06480 | Nail Technician | 2020-06-26 ~ 2021-12-31 |
| Kevin R Johnson | 20 Mountain Laurel Way, Portland, CT 06480 | Landscape Architect | 2020-08-01 ~ 2021-07-31 |
| Aaron A Adams | 138 High Street, Portland, CT 06480 | Licensed Practical Nurse | 2020-06-01 ~ 2021-05-31 |
| Amanda R. Weinberger | 270 Main St. Suite A, Portland, CT 06480 | Advanced Practice Registered Nurse | 2020-08-01 ~ 2021-07-31 |
| Karen L Cianci | 3 Myrtle Rd, Portland, CT 06480 | Hairdresser/cosmetician | 2020-07-01 ~ 2022-06-30 |
| Joseph Bials | P.o. Box 546, Portland, CT 06480 | Sub-surface Sewage Installer | 2020-05-01 ~ 2021-04-30 |
| Olivia Jane Briggs | 6 Allen Street, Portland, CT 06480 | Radiographer | 2020-08-01 ~ 2021-07-31 |
| Donna M Dubay | 8 Penny Corner Road, Portland, CT 06480 | Registered Nurse | 2020-08-01 ~ 2021-07-31 |
| Find all Licenses in zip 06480 | |||
| City | PORTLAND |
| Zip Code | 06480 |
| License Type | Physician/Surgeon |
| License Type + County | Physician/Surgeon + PORTLAND |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Ronald Gundersen · Gundersen Construction | 21 Walnut Terr, Naugatuck, CT 06770 | Home Improvement Contractor | 1998-12-01 ~ 1999-11-30 |
| Jasen W Gundersen Md | 2760 Ne 48th St, Lighthouse Point, FL 33064-7114 | Physician/surgeon | 2016-07-01 ~ 2017-06-30 |
| Dan Gundersen · Gundersen Quality Homes | 111 Laurelton Rd, Mount Kisco, NY 10549-4247 | Home Improvement Contractor | 2018-02-20 ~ 2018-11-30 |
| Charles Gundersen | 38 Jensen St, Manchester, CT 06042 | Repairer of Weighing & Measuring Devices | 2020-01-01 ~ 2020-12-31 |
| Glenn R Gundersen Co | 369 South Union St, Guilford, CT 06437 | Home Improvement Contractor | 2018-12-01 ~ 2019-11-30 |
| Christopher El Khuri | 218 N Charles St, Baltimore, MD 21201-4021 | Physician/surgeon | ~ |
| Charles A Mauriello | P.o Box 570, Villanova, PA 19085 | Physician/surgeon | 2010-08-01 ~ 2011-07-31 |
| Charles Flack | Ohs 3rd Fl, San Bernadino, CA 92415 | Physician/surgeon | 1993-09-23 ~ 1994-07-31 |
| Charles M Dickson | 95 Day St, Granby, CT 06035 | Physician/surgeon | 2010-04-01 ~ 2011-03-31 |
| Charles F Stroebel IIi | Po Box 279, Andover, CT 06232-0279 | Physician/surgeon | 1998-03-16 ~ 1999-05-31 |
Please comment or provide details below to improve the information on CHARLES A GUNDERSEN.
| 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).