SUSAN D GLOVER (Credential# 547600) is licensed (Physician/surgeon) with Connecticut Department of Consumer Protection. The license effective date is July 1, 2020. The license expiration date date is June 30, 2021. The license status is ACTIVE.
SUSAN D GLOVER is licensed with the Department of Consumer Protection of Connecticut. The credential number is #1.029131. The credential type is physician/surgeon. The effective date is July 1, 2020. The expiration date is June 30, 2021. The business address is 3640 Main Street, Springfield, MA 01107-1139. The current status is active.
| Licensee Name | SUSAN D GLOVER |
| Credential ID | 547600 |
| Credential Number | 1.029131 |
| Credential Type | Physician/Surgeon |
| Business Address |
3640 Main Street Springfield MA 01107-1139 |
| Business Type | INDIVIDUAL |
| Status | ACTIVE - CURRENT |
| Active | 1 |
| Issue Date | 1988-06-17 |
| Effective Date | 2020-07-01 |
| Expiration Date | 2021-06-30 |
| Refresh Date | 2020-06-13 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 156438 | CSP.0016484 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 1999-03-01 | 2019-03-01 - 2021-02-28 | ACTIVE |
| Street Address | 3640 Main Street |
| City | SPRINGFIELD |
| State | MA |
| Zip Code | 01107-1139 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Raphael J De Lima | 3640 Main Street, Springfield, MA 01107-1139 | Physician/surgeon | 2008-10-14 ~ 2009-10-31 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Brian K Bredvik | 3640 Main St Ste 205, Springfield, MA 01107-1139 | Physician/surgeon | 2020-05-01 ~ 2021-04-30 |
| Phillip S Kick | 3640 Main St Ste 103, Springfield, MA 01107-1139 | Physician/surgeon | 2016-04-01 ~ 2017-03-31 |
| Mark A Jackowitz | 3640 Main St Ste 205, Springfield, MA 01107-1139 | Physician/surgeon | 2020-01-01 ~ 2020-12-31 |
| Philip Moraitis | 3640 Main St Ste 205, Springfield, MA 01107-1139 | Physician/surgeon | 2016-05-01 ~ 2017-04-30 |
| William C Tran | 3640 Main St Ste 103, Springfield, MA 01107-1139 | Physician/surgeon | 2014-08-01 ~ 2015-07-31 |
| Gregory J Faust | 3640 Main St Ste 205, Springfield, MA 01107-1139 | Physician/surgeon | 2014-04-01 ~ 2015-03-31 |
| Mohammad R Mostafavi | 3640 Main St Ste 103, Springfield, MA 01107-1139 | Physician/surgeon | ~ |
| Donald J Sonn | 3640 Main St Ste 103, Springfield, MA 01107-1139 | Physician/surgeon | ~ |
| Alexander M. Berry | 3640 Main St Ste 103, Springfield, MA 01107-1139 | Physician/surgeon | ~ |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Lauren Elizabeth Marshall | 945 Armory St, Springfield, MA 01107 | Physician Assistant | 2020-04-01 ~ 2021-03-31 |
| Jennifer L Fish | 367 Union Street, Springfield, MA 01107 | Hairdresser/cosmetician | ~ |
| Joseph Pagan | 59 Rowland Street, Springfield, MA 01107 | Medication Administration Certification | 2020-04-20 ~ 2022-04-19 |
| Daniel Laguerre | 382 Springfield St, Springfield, MA 01107 | Crane Operator | ~ |
| Kamal Kant Kalia | 2 Medical Center Drive, Springfield, MA 01107 | Physician/surgeon | 2020-03-01 ~ 2021-02-28 |
| Bushee Enterprises LLC | Po Box 1196, Southwick, MA 01107 | Home Improvement Contractor | 2015-12-01 ~ 2016-11-30 |
| B Lopez | 165 Prospect Street, Springfield, MA 01107 | Notary Public Appointment | 2011-10-01 ~ 2016-09-30 |
| Beth C Mcinerny | 260 Ware Road, Belchertown, MA 01107 | Registered Nurse | 2019-12-01 ~ 2020-11-30 |
| Jorge Enrique Rivera | 20 Narragansett Street, Springfield, MA 01107 | Professional Counselor | 2019-10-01 ~ 2020-09-30 |
| Rachael Hynds-decoteau | 22 Candice Cir, Springfield, MA 01107 | Controlled Substance Registration for Practitioner | 2019-09-19 ~ 2021-02-28 |
| Find all Licenses in zip 01107 | |||
| City | SPRINGFIELD |
| Zip Code | 01107 |
| License Type | Physician/Surgeon |
| License Type + County | Physician/Surgeon + SPRINGFIELD |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Steven R Lindheim | 10 Glover Avenue, Norwalk, CT 06850 | Physician/surgeon | 2003-09-18 ~ 2004-09-30 |
| Gerald Glover · G L Glover Construction | 20 School St, Shelton, CT 06484 | Home Improvement Contractor | 2017-12-01 ~ 2018-11-30 |
| Thomas L Glover · Glover Construction Co | Po Box 221, Shelton, CT 06484 | Home Improvement Contractor | 2019-12-01 ~ 2020-11-30 |
| Susan Waldman · Halpern | 52 Glover St., Fairfield, CT 06824 | Psychologist | 2003-05-02 ~ 2004-04-30 |
| Scott Glover · Glover Home Improvements | 123 Lake Drive, Oakdale, CT 06370 | Home Improvement Contractor | 2005-12-19 ~ 2006-11-30 |
| Susan A Glover | 910 Whalley Ave., New Haven, CT 06500 | Notary Public Appointment | 1976-06-23 ~ 1981-03-31 |
| Susan Kornacki | Apt 4m, Ny, NY 10014 | Physician/surgeon | 2012-03-01 ~ 2013-02-28 |
| Susan J Batlan Md | Eye Physician Associates of Hartford, West Hartford, CT 06107 | Physician/surgeon | 2000-07-27 ~ 2001-07-31 |
| Susan T Lubin | 58 Franklin Ave, Rye, NY 10580-2545 | Physician/surgeon | 2015-09-01 ~ 2016-08-31 |
| Susan D Dibs | 14 Fox Den Way, Woodbridge, CT 06525 | Physician/surgeon | 2006-04-13 ~ 2007-05-31 |
Please comment or provide details below to improve the information on SUSAN D GLOVER.
| 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).