CHARLES J KOPRIVA (Credential# 542477) is licensed (Physician/surgeon) with Connecticut Department of Consumer Protection. The license effective date is August 1, 2014. The license expiration date date is July 31, 2015. The license status is INACTIVE.
CHARLES J KOPRIVA is licensed with the Department of Consumer Protection of Connecticut. The credential number is #1.017658. The credential type is physician/surgeon. The effective date is August 1, 2014. The expiration date is July 31, 2015. The business address is 1250 Blaine Street, Port Townsend, WA 98368. The current status is inactive.
| Licensee Name | CHARLES J KOPRIVA |
| Credential ID | 542477 |
| Credential Number | 1.017658 |
| Credential Type | Physician/Surgeon |
| Business Address |
1250 Blaine Street Port Townsend WA 98368 |
| Business Type | INDIVIDUAL |
| Status | INACTIVE - LAPSED DUE TO NON-RENEWAL |
| Issue Date | 1976-01-06 |
| Effective Date | 2014-08-01 |
| Expiration Date | 2015-07-31 |
| Refresh Date | 2015-11-03 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 146311 | CSP.0006993 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 2004-05-04 | 2013-03-01 - 2015-02-28 | INACTIVE |
| Street Address | 1250 Blaine Street |
| City | Port Townsend |
| State | WA |
| Zip Code | 98368 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Brian Erickson | 615 22nd St, Port Townsend, WA 98368 | Engineer-in-training | 1999-02-09 ~ 2009-02-09 |
| Katie E Phillips | 821 Roosevelt Street, Port Townsend, WA 98368 | Physical Therapist Assistant | 2009-03-03 ~ 2010-04-30 |
| Timothy G Moore | 2023 East Sims Way #408, Pt, WA 98368 | Advanced Emergency Medical Technician | ~ 1998-10-01 |
| Hope M Maloney | 1218 Rose St, Port Townsend, WA 98368-4026 | Professional Counselor | 2015-03-01 ~ 2016-02-29 |
| Gary M Arbuckle | 2078 Victoria Ave, Port Townsend, WA 98368-7327 | Paramedic | 2019-05-01 ~ 2020-04-30 |
| Ayla Skipper | 1626 Lawrence St, Port Townsend, WA 98368-8032 | Registered Nurse | 2019-05-06 ~ 2019-10-31 |
| City | Port Townsend |
| Zip Code | 98368 |
| License Type | Physician/Surgeon |
| License Type + County | Physician/Surgeon + Port Townsend |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| George R Kopriva | Professional Engineer | 1989-02-24 ~ 1990-01-31 | |
| Charles Flack | Ohs 3rd Fl, San Bernadino, CA 92415 | Physician/surgeon | 1993-09-23 ~ 1994-07-31 |
| Charles L Larkin Jr | Box 177, Middlebury, CT 06762 | Physician/surgeon | 2006-05-04 ~ 2007-05-31 |
| Christopher El Khuri | 218 N Charles St, Baltimore, MD 21201-4021 | Physician/surgeon | ~ |
| Charles M Dickson | 95 Day St, Granby, CT 06035 | Physician/surgeon | 2010-04-01 ~ 2011-03-31 |
| Charles W Boren | Rt 2 Box 106, Pecos, NM 87552 | Physician/surgeon | 1993-05-25 ~ 1994-06-30 |
| Charles F Stroebel IIi | Po Box 279, Andover, CT 06232-0279 | Physician/surgeon | 1998-03-16 ~ 1999-05-31 |
| Charles A Mauriello | P.o Box 570, Villanova, PA 19085 | Physician/surgeon | 2010-08-01 ~ 2011-07-31 |
| Charles D Bizilj Jr | 183 Hillside Rd, Ashford, CT 06278-2206 | Physician/surgeon | 2020-08-01 ~ 2021-07-31 |
| Charles E Wexler | P O Box 572499, Tarzana, CA 91357-2499 | Physician/surgeon | 2008-06-24 ~ 2009-08-31 |
Please comment or provide details below to improve the information on CHARLES J KOPRIVA.
| 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).