JERRY W VLASAK JR (Credential# 550319) is licensed (Physician/surgeon) with Connecticut Department of Consumer Protection. The license effective date is May 11, 1999. The license expiration date date is May 31, 2000. The license status is INACTIVE.
JERRY W VLASAK JR is licensed with the Department of Consumer Protection of Connecticut. The credential number is #1.032718. The credential type is physician/surgeon. The effective date is May 11, 1999. The expiration date is May 31, 2000. The business address is 5699 Kanan Road, Agoura Hills, CA 91301. The current status is inactive.
Licensee Name | JERRY W VLASAK JR |
Credential ID | 550319 |
Credential Number | 1.032718 |
Credential Type | Physician/Surgeon |
Business Address |
5699 Kanan Road Agoura Hills CA 91301 |
Business Type | INDIVIDUAL |
Status | INACTIVE - LAPSED DUE TO NON-RENEWAL |
Issue Date | 1992-12-04 |
Effective Date | 1999-05-11 |
Expiration Date | 2000-05-31 |
Refresh Date | 2009-07-08 |
Licensee Name | Office Address | Credential | Effective / Expiration |
---|---|---|---|
Jerry W Vlasak Jr | Waterbury Hospital, Waterbury, CT 06721 | Controlled Substance Registration for Practitioner | 1997-03-18 ~ 1998-02-28 |
Street Address | 5699 Kanan Road |
City | Agoura Hills |
State | CA |
Zip Code | 91301 |
Licensee Name | Office Address | Credential | Effective / Expiration |
---|---|---|---|
James E Drews | 29259 W Lake Vista Dr, Agoura, CA 91301 | Architect | 2019-08-01 ~ 2020-07-31 |
Tammy A Cohen | 30601 Sandtrap Drive, Agoura Hills, CA 91301 | Speech and Language Pathologist | 2001-02-21 ~ 2002-04-30 |
Prescriptions By Mail Inc | 5210 Lewis Rd Suite #5, Agoura Hills, CA 91301 | Nonresident Pharmacy | 2000-03-01 ~ 2000-08-31 |
Linda L Tatum | 5364 Lewis Rd, Agoura Hills, CA 91301 | Real Estate Salesperson | ~ |
John E Ireland | 5724 Willowtree Drive, Agoura Hills, CA 91301-1574 | Professional Engineer | 2020-02-01 ~ 2021-01-31 |
Open Medicine Foundation Inc | 29302 Laro Dr, Agoura Hills, CA 91301-1608 | Public Charity | 2019-12-01 ~ 2020-11-30 |
Peter A Kraut | 5346 Ambridge Dr, Calabasas, CA 91301-2304 | Professional Engineer | 2020-02-01 ~ 2021-01-31 |
Peter J Jensen | 5015 Ambridge Dr, Agoura Hills, CA 91301-2333 | Physician/surgeon | 1980-01-16 ~ 1983-05-30 |
Nationwide Medical Inc | 29903 Agoura Rd Ste 120, Agoura Hills, CA 91301-2513 | Wholesaler of Drugs, Cosmetics & Medical Devices | 2020-07-01 ~ 2021-06-30 |
Joni and Friends | 30009 Ladyface Ct, Agoura Hills, CA 91301-2583 | Public Charity | 2019-12-02 ~ 2020-11-30 |
Find all Licenses in zip 91301 |
City | Agoura Hills |
Zip Code | 91301 |
License Type | Physician/Surgeon |
License Type + County | Physician/Surgeon + Agoura Hills |
Licensee Name | Office Address | Credential | Effective / Expiration |
---|---|---|---|
Jerry Harwood Md | 51 Forest Ave No. 105, Old Greenwich, CT 06870 | Physician/surgeon | 1998-06-29 ~ 1999-06-30 |
Jerry L Greenburg | 456 Water St, Celebration, FL 34747-4977 | Physician/surgeon | 2020-04-01 ~ 2021-03-31 |
Jerry J Jaboin Md | 24 Ladue Mnr, Saint Louis, MO 63124-1821 | Physician/surgeon | 2012-08-01 ~ 2013-07-31 |
Jerry J Thomas | 1065 Us Highway 22 Ste 3d, Bridgewater, NJ 08807-2949 | Physician/surgeon | 2010-08-01 ~ 2011-07-31 |
Jerry D Ballard | 165 Jeffrey Lane, Springfield, MA 01089 | Physician/surgeon | 1995-06-12 ~ 1996-07-31 |
Jerry Sheen | 510-3d Auten Road, Hillsborough, NJ 08844 | Physician/surgeon | 2004-12-13 ~ 2005-03-31 |
Jerry Goldfarb Md | 30 Brodwood Drive, Stamford, CT 06902 | Physician/surgeon | 1999-08-26 ~ 2000-08-31 |
Maria L Webster | 6112 Jerry's Drive, Columbia, MD 21044 | Physician/surgeon | 2003-11-17 ~ 2004-11-30 |
Ann-jerry Peters | 4996 Taylor Way, El Dorado Hills, CA 95762-7531 | Physician/surgeon | 2011-09-01 ~ 2012-08-31 |
H Paul Winalski Md | 186 Jerry Browne Road, Mystic, CT 06355 | Physician/surgeon | 2010-04-01 ~ 2011-03-31 |
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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).