KEITH SCOTT MD (Credential# 546424) is licensed (Physician/surgeon) with Connecticut Department of Consumer Protection. The license effective date is January 1, 2020. The license expiration date date is December 31, 2020. The license status is ACTIVE.
KEITH SCOTT MD is licensed with the Department of Consumer Protection of Connecticut. The credential number is #1.027188. The credential type is physician/surgeon. The effective date is January 1, 2020. The expiration date is December 31, 2020. The business address is 1349 Altoona Pillar Rock Rd, Rosburg, WA 98643-9671. The current status is active.
| Licensee Name | KEITH SCOTT MD |
| Credential ID | 546424 |
| Credential Number | 1.027188 |
| Credential Type | Physician/Surgeon |
| Business Address |
1349 Altoona Pillar Rock Rd Rosburg WA 98643-9671 |
| Business Type | INDIVIDUAL |
| Status | ACTIVE - CURRENT |
| Active | 1 |
| Issue Date | 1986-04-21 |
| Effective Date | 2020-01-01 |
| Expiration Date | 2020-12-31 |
| Refresh Date | 2020-02-10 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 157161 | CSP.0013966 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 1999-03-01 | 2017-03-01 - 2019-02-28 | LAPSED |
| Street Address | 1349 ALTOONA PILLAR ROCK RD |
| City | ROSBURG |
| State | WA |
| Zip Code | 98643-9671 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Kimberly Emmick | 1659 Pillar Rock Rd, Rosburg, WA 98643-9619 | Dietitian/nutritionist | ~ |
| City | ROSBURG |
| Zip Code | 98643 |
| License Type | Physician/Surgeon |
| License Type + County | Physician/Surgeon + ROSBURG |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Keith C Boldon Md | Keith Boldon Md, Cheshire, CT 06410 | Physician/surgeon | 2020-03-01 ~ 2021-02-28 |
| Keith B Quencer | 198 Edwards St Apt 4, New Haven, CT 06511-3702 | Physician/surgeon | 2017-11-01 ~ 2018-10-31 |
| Keith M Spellman | Po Box 320757, Los Gatos, CA 95032-0112 | Physician/surgeon | 2018-09-01 ~ 2019-08-31 |
| Keith Ray Hodge Md | 95 Dover Rd, W Hartford, CT 06119 | Physician/surgeon | 2001-03-12 ~ 2002-03-31 |
| Keith A Kaplan | 24 Carriage Dr, Farmington, CT 06032-2704 | Physician/surgeon | 2020-04-01 ~ 2021-03-31 |
| Keith A Vom Eigen | 37 Hobson Ave, Windsor, CT 06095 | Physician/surgeon | 2020-01-01 ~ 2020-12-31 |
| Keith Gallagher | 11 Bishop St, New Haven, CT 06511-3931 | Physician/surgeon | 2020-04-01 ~ 2021-03-31 |
| Keith A Hernandez Md | 193 River Rd, Madison, CT 06443 | Physician/surgeon | 2020-06-01 ~ 2021-05-31 |
| Keith A Cauley | 33 Fairview Dr, Farmington, CT 06032-2516 | Physician/surgeon | 2020-01-24 ~ 2020-08-31 |
| Keith J Champney | 17 Ewell Ave, Lexington, MA 02421 | Physician/surgeon | 1999-10-14 ~ 2000-08-31 |
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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).