KEVIN D DIECKHAUS (Credential# 552890) is licensed (Physician/surgeon) with Connecticut Department of Consumer Protection. The license effective date is March 1, 2020. The license expiration date date is February 28, 2021. The license status is ACTIVE.
KEVIN D DIECKHAUS is licensed with the Department of Consumer Protection of Connecticut. The credential number is #1.035297. The credential type is physician/surgeon. The effective date is March 1, 2020. The expiration date is February 28, 2021. The business address is Uconn Health Ctr, Farmington, CT 06030-0001. The current status is active.
| Licensee Name | KEVIN D DIECKHAUS |
| Credential ID | 552890 |
| Credential Number | 1.035297 |
| Credential Type | Physician/Surgeon |
| Business Address |
Uconn Health Ctr Farmington CT 06030-0001 |
| Business Type | INDIVIDUAL |
| Status | ACTIVE - CURRENT |
| Active | 1 |
| Issue Date | 1996-06-14 |
| Effective Date | 2020-03-01 |
| Expiration Date | 2021-02-28 |
| Refresh Date | 2019-12-29 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 184695 | CSP.0025738 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 1999-03-01 | 2019-03-01 - 2021-02-28 | ACTIVE |
| Street Address | UCONN HEALTH CTR |
| City | FARMINGTON |
| State | CT |
| Zip Code | 06030-0001 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Martin Freilich | Uconn Health Ctr, Farmington, CT 06032 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Sandra A Barnosky Aprn | Uconn Health Ctr, Farmington, CT 06030-0001 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| George Y Wu Md | Uconn Health Ctr, Farmington, CT 06030-1239 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Steven M Lepowsky | Uconn Health Ctr, Farmington, CT 06030-3905 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Mark L Metersky | Uconn Health Ctr, Farmington, CT 06030-0001 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Cheryl A Oncken Md | Uconn Health Ctr, Farmington, CT 06030-0001 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Edward Thibodeau Dmd | Uconn Health Ctr, Farmington, CT 06030 | Dentist | 2018-10-01 ~ 2019-09-30 |
| William Vargas | Uconn Health Ctr, Farmington, CT 06030-0001 | Controlled Substance Registration for Practitioner | 2017-03-01 ~ 2019-02-28 |
| Michael S Dahn Md | Uconn Health Ctr, Farmington, CT 06030-3955 | Controlled Substance Registration for Practitioner | 2015-03-01 ~ 2017-02-28 |
| Steven Presciutti | Uconn Health Ctr, Farmington, CT 06030-0001 | Controlled Substance Registration for Practitioner | 2013-03-01 ~ 2015-02-28 |
| Find all Licenses in the same address | |||
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Wendy A Miller | Mc1921 Farmington Ave # 263, Farmington, CT 06030-0001 | Physician/surgeon | 2020-06-01 ~ 2021-05-31 |
| Jason J Ziegler | 2 Courthouse Square, Farmington, CT 06030-0001 | Real Estate Salesperson | 2020-06-01 ~ 2021-05-31 |
| Bryden T Considine | L2104 of Medicine Rm, Farmington, CT 06030-0001 | Resident Physician | 2017-07-03 ~ 2021-06-30 |
| Dillon Paulo | 4260 Cordoba Ct, Farmington, CT 06030-0001 | Resident Physician | 2020-07-01 ~ 2024-06-30 |
| Erica Shen Nofziger | 263 Farmington Ave, Farmington, CT 06030-0001 | Resident Physician | 2020-07-01 ~ 2027-06-30 |
| Omar Ibrahim | 263 Farmington Ave # Mc-1321, Farmington, CT 06030-0001 | Physician/surgeon | 2020-06-01 ~ 2021-05-31 |
| Jillian L Fortier | Uconn Health Center, Department of Surgery, Farmington, CT 06030-0001 | Physician/surgeon | 2020-05-01 ~ 2021-04-30 |
| Douglas Zelisko | 263 Farmington Ave Dept Of, Farmington, CT 06030-0001 | Physician/surgeon | 2020-04-23 ~ 2021-01-31 |
| Ruchir D Trivedi | 263 Farmington Ave # Mc-1405, Farmington, CT 06030-0001 | Physician/surgeon | 2020-06-01 ~ 2021-05-31 |
| Rawan J.j. Sarsour | 263 Farmington Ave # Mc3905, Farmington, CT 06030-0001 | Provisional Faculty Dentist | 2020-04-21 ~ 2021-04-30 |
| Find all Licenses in zip 06030-0001 | |||
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Eric Anthony Brueckner | 263 Farmington Ave., Farmington, CT 06030 | Physician/surgeon | 2020-08-01 ~ 2021-07-31 |
| Derrick B Bremang | Residency Program, Farmington, CT 06030 | Physician/surgeon | 2020-06-01 ~ 2021-06-30 |
| David M Shafer | Uconn Health Center, Farmington, CT 06030 | Dentist | 2020-07-01 ~ 2021-06-30 |
| Michael J Murphy | Dept of Dermatology, Farmington, CT 06030 | Physician/surgeon | 2020-09-01 ~ 2021-08-31 |
| Richard F Kaplan | Univ. of Ct., Farmington, CT 06030 | Psychologist | 2020-06-01 ~ 2021-05-31 |
| Nicholas George Vitale | 22 Woods Drive, Norwich, CT 06030 | Casino Class I Employee | 2019-12-03 ~ 2020-10-31 |
| Bruce E Gould | Univ of Conn Health Center, Farmington, CT 06030 | Physician/surgeon | 2020-04-01 ~ 2021-03-31 |
| Vinayak M Sathe | Uconn Health Center,263 Farmington Ave, Farmington, CT 06030 | Physician/surgeon | 2020-06-01 ~ 2021-05-31 |
| Shobhana Pathani | Department of Medicine, 263 Farmington Ave, CT 06030 | Physician/surgeon | 2020-06-01 ~ 2021-05-31 |
| Patricia L Almeida | John Dempsey Hospital, Farmington, CT 06030 | Registered Nurse | 2020-04-01 ~ 2021-03-31 |
| Find all Licenses in zip 06030 | |||
| City | FARMINGTON |
| Zip Code | 06030 |
| License Type | Physician/Surgeon |
| License Type + County | Physician/Surgeon + FARMINGTON |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Kevin L Soe | 26 Jasmine Dr, Middletown, NY 10940-5046 | Physician/surgeon | 2015-08-01 ~ 2016-07-31 |
| Kevin Y Pei | Po Box 208062, New Haven, CT 06520 | Physician/surgeon | 2018-06-01 ~ 2019-05-31 |
| Kevin J Tally | 16 Rip Rd, Hanover, NH 03755-1614 | Physician/surgeon | 2020-05-01 ~ 2021-04-30 |
| Kevin W Dickey Md | Po Box 217, New Britain, CT 06050-0217 | Physician/surgeon | 2014-09-01 ~ 2015-08-31 |
| Kevin P Becker | 37 Quail Run, Madison, CT 06443-1946 | Physician/surgeon | 2020-03-01 ~ 2021-02-28 |
| Kevin P Baruzzi | Po Box 1702, Lenox, MA 01240-1702 | Physician/surgeon | 2019-07-01 ~ 2020-06-30 |
| Kevin D Mcmahon | 546 So Broad St, Meriden, CT 06450 | Physician/surgeon | 2019-09-01 ~ 2020-08-31 |
| Kevin K Lenhart | 112 Quarry Rd Ste 400, Trumbull, CT 06611-4877 | Physician/surgeon | 2020-04-01 ~ 2021-03-31 |
| Kevin Chen | 200 Evergreen Ave, Hamden, CT 06518-2742 | Physician/surgeon | 2019-11-01 ~ 2020-10-31 |
| Kevin Math | 519 E 86th St Apt 2c, New York, NY 10028-7543 | Physician/surgeon | 2020-05-01 ~ 2021-04-30 |
Please comment or provide details below to improve the information on KEVIN D DIECKHAUS.
| 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).