JOHN R IACOVINO MD (Credential# 542006) is licensed (Physician/surgeon) with Connecticut Department of Consumer Protection. The license effective date is February 26, 2004. The license expiration date date is February 28, 2005. The license status is INACTIVE.
JOHN R IACOVINO MD is licensed with the Department of Consumer Protection of Connecticut. The credential number is #1.016652. The credential type is physician/surgeon. The effective date is February 26, 2004. The expiration date is February 28, 2005. The business address is 149 Legacy Woods Dr, Wallace, NC 28466. The current status is inactive.
| Licensee Name | JOHN R IACOVINO MD |
| Credential ID | 542006 |
| Credential Number | 1.016652 |
| Credential Type | Physician/Surgeon |
| Business Address |
149 Legacy Woods Dr Wallace NC 28466 |
| Business Type | INDIVIDUAL |
| Status | INACTIVE - LAPSED DUE TO NON-RENEWAL |
| Issue Date | 1974-05-17 |
| Effective Date | 2004-02-26 |
| Expiration Date | 2005-02-28 |
| Refresh Date | 2009-07-11 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 229404 | CSP.0029095 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 2004-02-29 - 2005-02-28 | INACTIVE | |
| 157696 | CSP.0019725 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 1993-11-08 - 1995-11-01 | INACTIVE |
| Street Address | 149 LEGACY WOODS DR |
| City | WALLACE |
| State | NC |
| Zip Code | 28466 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Anita D Iacovino | 149 Legacy Woods Dr, Wallace, NC 28466 | Registered Nurse | 2005-07-11 ~ 2006-08-31 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Robert B Romines | 609 N Graham St, Wallace, NC 28466 | Heating, Piping & Cooling Limited Journeyperson | 2017-09-01 ~ 2018-08-31 |
| Whisper Soft Mills Inc | 127 Rockfish Plaza, Wallace, NC 28466 | Manufacturer of Bedding & Upholstered Furniture | 2008-05-06 ~ 2009-04-30 |
| Dianne L Henderson | 783 James Road, Wallace, NC 28466 | Registered Nurse | 2006-09-21 ~ 2007-11-30 |
| River Landing | 110 River Village Pl, Wallace, NC 28466-1568 | Interstate Land Sales Registration | 2013-01-01 ~ 2013-12-31 |
| Keri Phaneuf | 128 Firefly Dr, Wallace, NC 28466-2372 | Dental Hygienist | 1995-09-08 ~ 1996-08-31 |
| Frances M Smith | 208 Cedar Point Dr, Wallace, NC 28466-2391 | Registered Nurse | 2002-01-08 ~ 2010-02-28 |
| Gene A Stallings | 324 River Rd, Wallace, NC 28466-6140 | Heating, Piping & Cooling Limited Journeyperson | ~ |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Taresa Lynn Nantt | 11093 Limestone Drive #13, Wallace, CA 95254 | Registered Nurse | 2019-10-01 ~ 2020-09-30 |
| City | WALLACE |
| Zip Code | 28466 |
| License Type | Physician/Surgeon |
| License Type + County | Physician/Surgeon + WALLACE |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| John T Thompson | Physician Pavilion W, Towson, MD 21204 | Physician/surgeon | 2020-07-01 ~ 2021-06-30 |
| Patsy W Iacovino Jr | 142 Morris St, Waterbury, CT 06705 | Barber | 2006-05-09 ~ 2008-05-31 |
| Anita D Iacovino | 149 Legacy Woods Dr, Wallace, NC 28466 | Registered Nurse | 2005-07-11 ~ 2006-08-31 |
| Patrick W Iacovino | 263 Short Beach Road, East Haven, CT 06512 | Massage Therapist | 2012-05-01 ~ 2014-04-30 |
| Corrine Iacovino | 42 Platt Street, Waterbury, CT 06700 | Notary Public Appointment | 1962-05-01 ~ 1967-03-31 |
| John S Kennedy | Psc 836 Box 56 | Physician/surgeon | 2002-03-19 ~ 2002-12-31 |
| John C Radford | Po Box 248, Ellicottville, NY 14731-0248 | Physician/surgeon | ~ |
| John W Blanton Jr | Guilford, CT 06437 | Physician/surgeon | 2018-12-01 ~ 2019-11-30 |
| John T Rigney | Po Box 252, Chappaqua, NY 10514 | Physician/surgeon | 1998-09-17 ~ 1999-09-30 |
| John A Day Jr | P.o. Box 1018, Woodstock, CT 06281 | Physician/surgeon | 2019-10-01 ~ 2020-09-30 |
Please comment or provide details below to improve the information on JOHN R IACOVINO MD.
| 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).