DAVID R POLKE (Credential# 547652) is licensed (Physician/surgeon) with Connecticut Department of Consumer Protection. The license effective date is May 1, 2020. The license expiration date date is April 30, 2021. The license status is ACTIVE.
DAVID R POLKE is licensed with the Department of Consumer Protection of Connecticut. The credential number is #1.029220. The credential type is physician/surgeon. The effective date is May 1, 2020. The expiration date is April 30, 2021. The business address is 687 Straits Tpke Ste 2a, Middlebury, CT 06762-2846. The current status is active.
| Licensee Name | DAVID R POLKE |
| Credential ID | 547652 |
| Credential Number | 1.029220 |
| Credential Type | Physician/Surgeon |
| Business Address |
687 Straits Tpke Ste 2a Middlebury CT 06762-2846 |
| Business Type | INDIVIDUAL |
| Status | ACTIVE - PRIOR DISCIPLINE |
| Active | 1 |
| Issue Date | 1988-07-01 |
| Effective Date | 2020-05-01 |
| Expiration Date | 2021-04-30 |
| Refresh Date | 2020-04-17 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 158021 | CSP.0017838 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 1999-03-01 | 2019-03-01 - 2021-02-28 | ACTIVE |
| Street Address | 687 STRAITS TPKE STE 2A |
| City | MIDDLEBURY |
| State | CT |
| Zip Code | 06762-2846 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Paula A Moynahan | 687 Straits Tpke Ste 1a, Middlebury, CT 06762-2846 | Physician/surgeon | 2020-08-01 ~ 2021-07-31 |
| Preferred Home Care, LLC | 687 Straits Tpke, Middlebury, CT 06762-2846 | Home Health Care | 2017-01-01 ~ 2019-12-31 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Patricia E Rosa · Lambo | 76 East Farm Rd, Middlebury, CT 06762 | Registered Nurse | 2020-08-01 ~ 2021-07-31 |
| Kathy Ann Calo · Bellino | 116 Carriage Drive, Middlebury, CT 06762 | Hairdresser/cosmetician | 2020-06-01 ~ 2022-05-31 |
| Laurie V Massetti | 60 Yale Avenue, Middlebury, CT 06762 | Registered Nurse | 2020-07-01 ~ 2021-06-30 |
| Timex Corp | Park Rd Ext, Middlebury, CT 06762 | Operator of Weighing & Measuring Devices | 2020-08-01 ~ 2021-07-31 |
| Margaret E Mowrey | 57 Marney Drive, Middlebury, CT 06762 | Licensed Clinical Social Worker | 2020-08-01 ~ 2021-07-31 |
| Giuseppe Tripodi | 687 Straits Tpk, Middlebury, CT 06762 | Physician/surgeon | 2020-08-01 ~ 2021-07-31 |
| Elise L Callahan | 77 Christian Rd, Middlebury, CT 06762 | Registered Nurse | 2020-08-01 ~ 2021-07-31 |
| Michelle King | 91 Kissewaug Rd, Middlebury, CT 06762 | Registered Nurse | 2020-07-01 ~ 2021-06-30 |
| Michael F Simms IIi | 80 Burr Hall Road, Middlebury, CT 06762 | Physician/surgeon | 2020-07-01 ~ 2021-06-30 |
| Kelly M Barbaris | 62 Yale Avenue, Middlebury, CT 06762 | Physical Therapist | 2020-07-01 ~ 2021-06-30 |
| Find all Licenses in zip 06762 | |||
| City | MIDDLEBURY |
| Zip Code | 06762 |
| License Type | Physician/Surgeon |
| License Type + County | Physician/Surgeon + MIDDLEBURY |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Frank Polke & Son Inc. | 1209 Post Rd, Fairfield, CT 06824-6007 | Funeral Home | 2019-07-01 ~ 2020-06-30 |
| Lesko & Polke Funeral Home LLC | 1209 Post Rd, Fairfield, CT 06824-6007 | Funeral Home | 2020-07-01 ~ 2021-06-30 |
| David J Martin | C/o O.s.m., Trumbull, CT 06611 | Physician/surgeon | 2019-12-01 ~ 2020-11-30 |
| David J Rea | 5699 N Centerpark Way Apt 502, Glendale, WI 53217-4571 | Physician/surgeon | ~ |
| David I Soybel | Fmb 109, New Haven, CT 06511 | Physician/surgeon | 1992-10-23 ~ 1993-11-30 |
| David G. Srour Md | Rockville, MD 20850 | Physician/surgeon | 2012-07-01 ~ 2013-06-30 |
| David H Barad | 21 E 69th St, New York, NY 10021-4917 | Physician/surgeon | ~ |
| David Kessler | 615 W 131st St, New York, NY 10027 | Physician/surgeon | ~ |
| David A Crowe | Po Box 677, Millwood, NY 10546-0677 | Physician/surgeon | 2020-05-01 ~ 2021-04-30 |
| David M Lans | 838 Pelhamdale Ave, New Rochelle, NY 10801-1032 | Physician/surgeon | ~ |
Please comment or provide details below to improve the information on DAVID R POLKE.
| 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).