MAX L WALLACE JR (Credential# 544520) is licensed (Physician/surgeon) with Connecticut Department of Consumer Protection. The license effective date is September 1, 2017. The license expiration date date is August 31, 2018. The license status is INACTIVE.
MAX L WALLACE JR is licensed with the Department of Consumer Protection of Connecticut. The credential number is #1.023301. The credential type is physician/surgeon. The effective date is September 1, 2017. The expiration date is August 31, 2018. The business address is 383 Rockwood Drive, Southington, CT 06489. The current status is inactive.
Licensee Name | MAX L WALLACE JR |
Credential ID | 544520 |
Credential Number | 1.023301 |
Credential Type | Physician/Surgeon |
Business Address |
383 Rockwood Drive Southington CT 06489 |
Business Type | INDIVIDUAL |
Status | INACTIVE - LAPSED DUE TO NON-RENEWAL |
Issue Date | 1982-01-13 |
Effective Date | 2017-09-01 |
Expiration Date | 2018-08-31 |
Refresh Date | 2018-12-04 |
Street Address | 383 Rockwood Drive |
City | Southington |
State | CT |
Zip Code | 06489 |
Licensee Name | Office Address | Credential | Effective / Expiration |
---|---|---|---|
Sarah M Moon | 321 Pilgrim Lane, Southington, CT 06489 | Esthetician | ~ |
Joanna Milewski | 23 Stacy Cate Drive, Southington, CT 06489 | Registered Nurse | 2020-07-01 ~ 2021-06-30 |
Richard M Testa | 81 Winter Park Road, Southington, CT 06489 | Massage Therapist | 2020-08-01 ~ 2022-07-31 |
Valley Roofing LLC | 88 Ladyslipper Lane, Southington, CT 06489 | Home Improvement Contractor | ~ |
Dunkin Donuts · New England Donuts LLC | 856 Queen St, Southington, CT 06489 | Bakery | 2020-07-01 ~ 2021-06-30 |
Elizabeth E Pizzuto | 45 Water Street, Southington, CT 06489 | Real Estate Salesperson | 2020-06-18 ~ 2021-05-31 |
Nicholas C Ingel | 515 West Street, Southington, CT 06489 | Heating, Piping & Cooling Limited Journeyperson | 2020-06-23 ~ 2021-08-31 |
Tyrone J Correa | 84 Minthal Drive, Southington, CT 06489 | Real Estate Salesperson | 2020-06-19 ~ 2021-05-31 |
Marilyn F Coppola | 114 Spring Hill Rd, Southington, CT 06489 | Registered Nurse | 2020-08-01 ~ 2021-07-31 |
Christine M Liebler | 30 Sultana Terrace, Southington, CT 06489 | Registered Nurse | 2020-07-01 ~ 2021-06-30 |
Find all Licenses in zip 06489 |
City | Southington |
Zip Code | 06489 |
License Type | Physician/Surgeon |
License Type + County | Physician/Surgeon + Southington |
Licensee Name | Office Address | Credential | Effective / Expiration |
---|---|---|---|
Keri A Wallace Md | Ct Pediatrics At Chc, Hartford, CT 06106 | Physician/surgeon | 2020-06-01 ~ 2021-05-31 |
Christopher A Wallace | 6 Charlotte Ct, Avon, CT 06001-2257 | Physician/surgeon | 2020-06-01 ~ 2021-05-31 |
Ellen C Wallace | 25 Stearns Rd, Watertown, MA 02172 | Physician/surgeon | 1994-11-02 ~ 1995-12-31 |
Edward P Wallace Md | 285 Broad St, Meriden, CT 06450 | Physician/surgeon | 1999-02-11 ~ 2000-02-29 |
Michael Lloyd Wallace | 875 Greentree Rd, Pittsburgh, PA 15220-3508 | Physician/surgeon | ~ |
Kathleen A Wallace | 8 Springbrook Lane, Simsbury, CT 06070 | Physician/surgeon | 2018-06-01 ~ 2019-05-31 |
Sampath Gunda | 2181 Wallace Ave Apt 3e, Bronx, NY 10462-1827 | Physician/surgeon | 2013-05-23 ~ 2014-03-31 |
Albert J Gomez | 395 Wallace Road, Nashville, TN 37211 | Physician/surgeon | 1998-04-09 ~ 1999-04-30 |
Daniel Wallace Dahl | 40 Prospect Ave, Norwalk, CT 06850 | Physician/surgeon | 2018-01-01 ~ 2018-12-31 |
Wallace Duncan | 465 Buckland Hills, Manchester, CT 06050 | Physician/surgeon | ~ 1996-07-31 |
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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).