JERE T LICCIARDELLO (Credential# 547802) is licensed (Physician/surgeon) with Connecticut Department of Consumer Protection. The license effective date is September 30, 2005. The license expiration date date is October 31, 2006. The license status is INACTIVE.
JERE T LICCIARDELLO is licensed with the Department of Consumer Protection of Connecticut. The credential number is #1.029465. The credential type is physician/surgeon. The effective date is September 30, 2005. The expiration date is October 31, 2006. The business address is 400 Berywood Tr., Cleveland, TN 37312. The current status is inactive.
| Licensee Name | JERE T LICCIARDELLO |
| Credential ID | 547802 |
| Credential Number | 1.029465 |
| Credential Type | Physician/Surgeon |
| Business Address |
400 Berywood Tr. Cleveland TN 37312 |
| Business Type | INDIVIDUAL |
| Status | INACTIVE - LAPSED DUE TO NON-RENEWAL |
| Issue Date | 1988-09-16 |
| Effective Date | 2005-09-30 |
| Expiration Date | 2006-10-31 |
| Refresh Date | 2009-07-08 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 157107 | CSP.0016635 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 2003-03-01 - 2004-02-28 | INACTIVE |
| Street Address | 400 BERYWOOD TR. |
| City | CLEVELAND |
| State | TN |
| Zip Code | 37312 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Shaun Christopher Johnson | 5845 Frontage Rd Nw, Cleveland, TN 37312 | Registered Nurse - Temporary | 2017-06-07 ~ 2017-10-04 |
| Steven M Jackson | 2049 Rabbit Valley Road Nw, Cleveland, TN 37312 | Nursing Home Administrator | 2012-09-01 ~ 2014-08-31 |
| Janice D Rice | 176 Hunters Run Circle Nw, Cleveland, TN 37312 | Registered Nurse | 2008-12-19 ~ 2010-01-31 |
| Arlene A Mcaree | 2502 Overbrook Cir, Cleveland, TN 37312 | Registered Nurse | 2006-10-13 ~ 2007-10-31 |
| Nancy A Work | 215 Wilson Heights Cr, Cleveland, TN 37312 | Licensed Practical Nurse | 2005-11-21 ~ 2006-12-31 |
| Christine P Ward | 5117 Cindy Cr Nw, Cleveland, TN 37312 | Heating, Piping & Cooling Limited Journeyperson | 2006-09-01 ~ 2007-08-31 |
| Alexsandra Morgan Johnson | 5845 Frontage Rd Nw, Cleveland, TN 37312 | Registered Nurse - Temporary | 2017-06-07 ~ 2017-10-04 |
| Lisa S Moses | 1885 Partridge Rd Nw, Cleveland, TN 37312-2128 | Registered Nurse | 2020-01-01 ~ 2020-12-31 |
| Inna Skotsen | 2719 22nd St Nw, Cleveland, TN 37312-2310 | Licensed Practical Nurse - Temporary | 2019-04-24 ~ 2019-08-22 |
| Betty Bohannon Aprn | 133 Windcrest Pl Nw, Cleveland, TN 37312-3128 | Advanced Practice Registered Nurse | 2012-04-01 ~ 2013-03-31 |
| Find all Licenses in zip 37312 | |||
| City | CLEVELAND |
| Zip Code | 37312 |
| License Type | Physician/Surgeon |
| License Type + County | Physician/Surgeon + CLEVELAND |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Thomas Licciardello | 66 Sherman St, Cambridge, MA 02140 | Physician/surgeon | 2011-04-01 ~ 2012-03-31 |
| Grace M Jere Md | 12 Bailey Rd, Middletown, CT 06457 | Physician/surgeon | 2006-01-17 ~ 2007-02-28 |
| Janet Licciardello | 1915 Wynwqood Dr Nw, Cleveland, TN 37311 | Pharmacist | 2004-02-01 ~ 2005-01-31 |
| Jere K Murdoch | 2 Hummingbird Ct, Howell, NJ 07731-8835 | Professional Engineer | 2020-02-01 ~ 2021-01-31 |
| Jere W Planck | 5055 E. Washington St., Phoenix, AZ 85034 | Architect | 2015-08-01 ~ 2016-07-31 |
| Jere Rowland | 17 Bargate Rd, Clinton, CT 06413 | Home Improvement Salesperson | 2009-01-13 ~ 2009-11-30 |
| Jere Lifshitz | 110 East 71st St, New York, NY 10021 | Registered Nurse | 1996-07-15 ~ 1997-09-30 |
| Jere M Lacoske | 57 Gurley Rd, Waterford, CT 06385 | Electrical Unlimited Contractor | 2019-10-01 ~ 2020-09-30 |
| Jere W Dittrich | 38 Texel Drive, Springfield, MA 01108 | Registered Nurse | 2009-06-25 ~ 2010-06-30 |
| Jere G Adametz | 1 Alders Bridge Rd, Killingworth, CT 06419 | Real Estate Broker | 1999-06-09 ~ 2000-05-31 |
Please comment or provide details below to improve the information on JERE T LICCIARDELLO.
| 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).