DAVID M WILTERDINK MD (Credential# 544727) is licensed (Physician/surgeon) with Connecticut Department of Consumer Protection. The license effective date is April 1, 2020. The license expiration date date is March 31, 2021. The license status is ACTIVE.
DAVID M WILTERDINK MD is licensed with the Department of Consumer Protection of Connecticut. The credential number is #1.023759. The credential type is physician/surgeon. The effective date is April 1, 2020. The expiration date is March 31, 2021. The business address is 45 Green Hollow Rd, Danielson, CT 06239. The current status is active.
| Licensee Name | DAVID M WILTERDINK MD |
| Credential ID | 544727 |
| Credential Number | 1.023759 |
| Credential Type | Physician/Surgeon |
| Business Address |
45 Green Hollow Rd Danielson CT 06239 |
| Business Type | INDIVIDUAL |
| Status | ACTIVE - PRIOR DISCIPLINE |
| Active | 1 |
| Issue Date | 1982-07-07 |
| Effective Date | 2020-04-01 |
| Expiration Date | 2021-03-31 |
| Refresh Date | 2020-03-22 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 151205 | CSP.0010890 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 1999-03-01 | 2019-03-01 - 2021-02-28 | ACTIVE |
| 290969 | CSP.0031594 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 2001-11-16 | 2019-03-01 - 2021-02-28 | ACTIVE |
| Street Address | 45 GREEN HOLLOW RD |
| City | DANIELSON |
| State | CT |
| Zip Code | 06239 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Anthony J Purcell Do | 45 Green Hollow Rd, Danielson, CT 06239 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Sandra Elizabeth Gibson | 72 Westfield Ave, Danielson, CT 06239 | Licensed Practical Nurse | 2020-07-01 ~ 2021-06-30 |
| Meg A Collelo | 146 Wauregan Road, Danielson, CT 06239 | Combination Nail Technician, Esthetician Or Eyelash Technici | 2020-06-26 ~ 2022-04-30 |
| Matthew U Paquin | 20 Buck Street, Danielson, CT 06239 | Real Estate Salesperson | 2020-06-19 ~ 2021-05-31 |
| Carrie B Pichie | 702 Cook Hill Road, Danielson, CT 06239 | Psychologist | 2020-07-01 ~ 2021-06-30 |
| Saylee Phongsamphanh | 50 Ruth St, Danielson, CT 06239 | Emergency Medical Technician | 2017-07-25 ~ 2020-06-30 |
| Sarah R Gates - Williams | 42 Broad St, Danielson, CT 06239 | Notary Public Appointment | 2020-06-22 ~ 2025-06-30 |
| Christy W Atsales | 246 Broad Street, Danielson, CT 06239 | Notary Public Appointment | 2020-09-01 ~ 2025-08-31 |
| Bonnie Steele | 216 Mechanic Street, Danielson, CT 06239 | Medication Administration Certification | 2020-06-27 ~ 2022-06-26 |
| Leina'ala Rossman | 18 Prospect Ave. Apt H, Danielson, CT 06239 | Medication Administration Certification | 2020-08-08 ~ 2022-08-07 |
| Bashir Q Muhammad | 19 B Palmer St, Danielson, CT 06239 | Respiratory Care Practitioner | 2020-08-01 ~ 2021-07-31 |
| Find all Licenses in zip 06239 | |||
| City | DANIELSON |
| Zip Code | 06239 |
| License Type | Physician/Surgeon |
| License Type + County | Physician/Surgeon + DANIELSON |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Robin S Wilterdink | 9 General Patton Drive, Naugatuck, CT 06770 | Family Child Care Home | 2006-11-03 ~ |
| David I Soybel | Fmb 109, New Haven, CT 06511 | Physician/surgeon | 1992-10-23 ~ 1993-11-30 |
| David Chu Md | 358 W Hyerdale Dr, Goshen, CT 06756 | Physician/surgeon | 2020-05-01 ~ 2021-04-30 |
| David R Widrow Md | 22 Fifth St, Stamford, CT 06905 | Physician/surgeon | 2002-08-20 ~ 2003-10-31 |
| David C Kim | 1345 Rxr Plz, Uniondale, NY 11556-1301 | Physician/surgeon | 2019-04-01 ~ 2020-03-31 |
| David M Lans | 838 Pelhamdale Ave, New Rochelle, NY 10801-1032 | Physician/surgeon | ~ |
| David L Maxham | Box 517, Woodstock, VT 05091 | Physician/surgeon | 1994-03-07 ~ 1995-02-28 |
| David Zhou | 125 Paterson St, Meb 233, New Brunswick, NJ 08903 | Physician/surgeon | ~ |
| David M Drvaric | 516 Carew St, Springfield, MA 01104-2330 | Physician/surgeon | ~ |
| David Khaski | 372 Avenue U Ste 1b, Brooklyn, NY 11223-4052 | Physician/surgeon | ~ |
Please comment or provide details below to improve the information on DAVID M WILTERDINK 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).