ALICE D MICHTOM MD (Credential# 550906) is licensed (Physician/surgeon) with Connecticut Department of Consumer Protection. The license effective date is March 20, 1996. The license expiration date date is March 31, 1997. The license status is INACTIVE.
ALICE D MICHTOM MD is licensed with the Department of Consumer Protection of Connecticut. The credential number is #1.033307. The credential type is physician/surgeon. The effective date is March 20, 1996. The expiration date is March 31, 1997. The business address is 25 Reservoir St, Bethel, CT 06801. The current status is inactive.
| Licensee Name | ALICE D MICHTOM MD |
| Credential ID | 550906 |
| Credential Number | 1.033307 |
| Credential Type | Physician/Surgeon |
| Business Address |
25 Reservoir St Bethel CT 06801 |
| Business Type | INDIVIDUAL |
| Status | INACTIVE - LAPSED DUE TO NON-RENEWAL |
| Issue Date | 1993-09-10 |
| Effective Date | 1996-03-20 |
| Expiration Date | 1997-03-31 |
| Refresh Date | 2009-07-11 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 164496 | CSP.0021458 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 1996-03-01 - 1997-02-28 | INACTIVE |
| Street Address | 25 RESERVOIR ST |
| City | BETHEL |
| State | CT |
| Zip Code | 06801 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Maran Sady · Sady Construction | 25 Reservoir St, Bethel, CT 06801 | Home Improvement Contractor | 2000-12-01 ~ 2001-11-30 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| John Anthony Dulko | 6 Winthrop Road, Bethel, CT 06801 | Notary Public Appointment | 2020-06-26 ~ 2025-06-30 |
| Antonietta Sproviero-metaxas | 36 Quaker Ridge Road, Bethel, CT 06801 | Hairdresser/cosmetician | 2020-07-01 ~ 2022-06-30 |
| Mark K Roos | 6 Crestview Road, Bethel, CT 06801 | Licensed Clinical Social Worker | 2020-07-01 ~ 2021-06-30 |
| Susan Nguyen | 14b Cawley Ave., Bethel, CT 06801 | Esthetician | ~ |
| Blue Jay Orchards | 125 Plumtrees Rd, Bethel, CT 06801 | Operator of Weighing & Measuring Devices | 2020-08-01 ~ 2021-07-31 |
| Varano Bakery | 198 Greenwood Ave, Bethel, CT 06801 | Operator of Weighing & Measuring Devices | 2020-08-01 ~ 2021-07-31 |
| Nina M Kilcourse | 3 Bayberry Hill Rd, Bethel, CT 06801 | Hairdresser/cosmetician | 2020-09-01 ~ 2022-08-31 |
| Ralph Ramsdell · Big Y | 83 Stony Hill Road, Bethel, CT 06801 | Grocery Beer | 2020-04-18 ~ 2021-04-17 |
| Marilu F Jeton | 36 Weed Rd, Bethel, CT 06801 | Combination Nail Technician, Esthetician Or Eyelash Technici | ~ |
| Petagay V Hewitt | 44 Greenwood Avenue, Bethel, CT 06801 | Real Estate Salesperson | ~ |
| Find all Licenses in zip 06801 | |||
| City | BETHEL |
| Zip Code | 06801 |
| License Type | Physician/Surgeon |
| License Type + County | Physician/Surgeon + BETHEL |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Alice M Kim | 259 First St, Mineola, NY 11501 | Physician/surgeon | 2019-07-01 ~ 2020-06-30 |
| Alice Donna Kim | 29 E 7th St Apt 4w, New York, NY 10003-8021 | Physician/surgeon | 2020-03-01 ~ 2021-02-28 |
| Alice A Grabowski | 6 Germantown Rd, Danbury, CT 06810-5027 | Physician/surgeon | 2018-09-01 ~ 2019-08-31 |
| Alice Y Guh | 1021 Asylum Ave, Hartford, CT 06105 | Physician/surgeon | 2008-08-19 ~ 2009-10-31 |
| Alice S Cary | Amherst House, Kyoto 602 | Physician/surgeon | 1992-06-25 ~ 1993-06-30 |
| Alice Lin Yang Md | 10 High Wood Rd, Bloomfield, CT 06002 | Physician/surgeon | 2001-02-26 ~ 2002-04-30 |
| Ricardo I Zarzuela Jr | 2015 Alice St, Waycross, GA 31501-6209 | Physician/surgeon | 1980-08-21 ~ 1981-07-31 |
| Alice G Papsun Md | 2558 Whitney Ave #204, Hamden, CT 06518 | Physician/surgeon | 2020-04-01 ~ 2021-03-31 |
| Alice E Madwed | 110 Wedgewood Drive, Easton, CT 06612 | Physician/surgeon | 2016-04-01 ~ 2017-03-31 |
| Kevin P Banks | 188 Alice Drive, Coventry, CT 06238 | Physician/surgeon | 2007-07-26 ~ 2008-06-30 |
Please comment or provide details below to improve the information on ALICE D MICHTOM MD.
| 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).