GLENN D GRAHAM (Credential# 547355) is licensed (Physician/surgeon) with Connecticut Department of Consumer Protection. The license effective date is September 30, 1994. The license expiration date date is November 30, 1995. The license status is INACTIVE.
GLENN D GRAHAM is licensed with the Department of Consumer Protection of Connecticut. The credential number is #1.028742. The credential type is physician/surgeon. The effective date is September 30, 1994. The expiration date is November 30, 1995. The business address is 337 White Oaks Drive, Albuquerque, NM 87122. The current status is inactive.
| Licensee Name | GLENN D GRAHAM |
| Credential ID | 547355 |
| Credential Number | 1.028742 |
| Credential Type | Physician/Surgeon |
| Business Address |
337 White Oaks Drive Albuquerque NM 87122 |
| Business Type | INDIVIDUAL |
| Status | INACTIVE - LAPSED DUE TO NON-RENEWAL |
| Issue Date | 1987-12-18 |
| Effective Date | 1994-09-30 |
| Expiration Date | 1995-11-30 |
| Refresh Date | 2009-07-08 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 160529 | CSP.0017542 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 1993-08-24 - 1995-09-01 | INACTIVE |
| Street Address | 337 WHITE OAKS DRIVE |
| City | ALBUQUERQUE |
| State | NM |
| Zip Code | 87122 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Bonnie S Graham | 337 White Oak Dr Ne, Albuquerque, NM 87122 | Occupational Therapist | 1999-07-22 ~ 2001-07-31 |
| Soofia Khan | 1800 Barstow Street Ne, Albuquerque, NM 87122 | Physician/surgeon | 2008-02-04 ~ 2009-02-28 |
| Robert Quinn Md | 44 Cedar Hill Place Ne, Albuquerque, NM 87122 | Controlled Substance Registration for Practitioner | 2005-03-01 ~ 2006-02-28 |
| Stephanie S Quinn | 44 Cedar Hill Place Ne, Albuquerque, NM 87122 | Registered Nurse | 2004-10-04 ~ 2005-10-31 |
| Osman C Dokmeci | 795 Tramway Ln Ne Unit J, Albuquerque, NM 87122-1638 | Physician/surgeon | 2014-11-03 ~ 2015-11-30 |
| Futures for Children Inc | 9600 Tennyson St Ne, Albuquerque, NM 87122-2282 | Public Charity | 2015-06-01 ~ 2015-12-31 |
| Paul M Gladysz | 8209 Eagle Rock Ave Ne, Albuquerque, NM 87122-2705 | Architect | 2020-08-01 ~ 2021-07-31 |
| Edward S. Markman | 8801 Coral Satin Ct Ne, Albuquerque, NM 87122-3044 | Certified Public Accountant Certificate | ~ |
| Diane E Bilotta · Brown | 12080 Irish Mist Rd Ne, Albuquerque, NM 87122-3151 | Registered Nurse | 2019-09-01 ~ 2020-08-31 |
| Raven R Holm | 8516 Florence Ave Ne, Albuquerque, NM 87122-3884 | Engineer-in-training | ~ |
| Find all Licenses in zip 87122 | |||
| City | ALBUQUERQUE |
| Zip Code | 87122 |
| License Type | Physician/Surgeon |
| License Type + County | Physician/Surgeon + ALBUQUERQUE |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Glenn J. Freeman Md | P.o. Box 339, Englewood, FL 34295-0339 | Physician/surgeon | 2014-05-01 ~ 2015-04-30 |
| Arthur P Greenberg | 126 Graham St., Se, Pt. Charlotte, FL 33952 | Physician/surgeon | 1979-01-24 ~ 1982-01-31 |
| Andrew J Graham Md | 40 Temple St, New Haven, CT 06510 | Physician/surgeon | 2010-07-01 ~ 2011-06-30 |
| Kurt W Graham | 1220 Boren Ave Apt 805, Seattle, WA 98101-2712 | Physician/surgeon | ~ |
| Glenn D Pomerantz | 21 Livingston Rd, Sharon, MA 02067-2711 | Physician/surgeon | 2019-10-01 ~ 2020-09-30 |
| Glenn H Segal | 46 Sullivan Rd, New Milford, CT 06776 | Physician/surgeon | 2019-12-01 ~ 2020-11-30 |
| Glenn Flores | 282 Washington St, Hartford, CT 06106-3322 | Physician/surgeon | 2020-07-01 ~ 2021-06-30 |
| Glenn H Littell | 789 Central Ave, Dover, NH 03820 | Physician/surgeon | 2006-09-27 ~ 2007-09-30 |
| Glenn Gart Md | 72 Pine St, Bristol, CT 06010-6960 | Physician/surgeon | 2020-07-01 ~ 2021-06-30 |
| Glenn Feole Md | 90 Myrtle Ave, Westport, CT 06880 | Physician/surgeon | 1999-02-22 ~ 2000-02-29 |
Please comment or provide details below to improve the information on GLENN D GRAHAM.
| 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).