PAIBOON SIRIPONGWISHET (Credential# 553509) is licensed (Physician/surgeon) with Connecticut Department of Consumer Protection. The license effective date is February 14, 2000. The license expiration date date is April 30, 2001. The license status is INACTIVE.
PAIBOON SIRIPONGWISHET is licensed with the Department of Consumer Protection of Connecticut. The credential number is #1.035916. The credential type is physician/surgeon. The effective date is February 14, 2000. The expiration date is April 30, 2001. The business address is 255 Michelle Lane, Groton, CT 06340. The current status is inactive.
| Licensee Name | PAIBOON SIRIPONGWISHET |
| Credential ID | 553509 |
| Credential Number | 1.035916 |
| Credential Type | Physician/Surgeon |
| Business Address |
255 Michelle Lane Groton CT 06340 |
| Business Type | INDIVIDUAL |
| Status | INACTIVE - LAPSED DUE TO NON-RENEWAL |
| Issue Date | 1997-04-04 |
| Effective Date | 2000-02-14 |
| Expiration Date | 2001-04-30 |
| Refresh Date | 2009-07-08 |
| Street Address | 255 MICHELLE LANE |
| City | Groton |
| State | CT |
| Zip Code | 06340 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Elisha M Schauer | 255 Michelle Lane, Groton, CT 06340 | Tattoo Technician | 2019-09-01 ~ 2021-08-31 |
| Natalie L Dyer | 255 Michelle Lane, Groton, CT 06340 | Registered Nurse | 2019-07-01 ~ 2020-06-30 |
| Jennifer Bair · Orthouse | 255 Michelle Lane, Groton, CT 06340 | Dental Hygienist | 1998-02-25 ~ 1999-04-30 |
| Sandra D Price · Lambert | 255 Michelle Lane, Groton, CT 06340 | Registered Nurse | 1994-03-03 ~ 1995-02-28 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Swatiben R. Patel | 81 Charlton Lane, Groton, CT 06340 | Pharmacy Technician | 2020-06-26 ~ 2021-03-31 |
| Susan E Mammone | 39 Chestnut Hill Sq, Groton, CT 06340 | Real Estate Salesperson | 2020-06-23 ~ 2021-05-31 |
| Jennifer L Lundie | 302b Meridian Street, Groton, CT 06340 | Registered Nurse | 2020-08-01 ~ 2021-07-31 |
| Jennifer Gauthier | 55 Fieldside Drive # B, Groton, CT 06340 | Master's Level Social Worker - Temporary Permit | ~ |
| Anthony Di Lullo Md | Thameside Ob/gyn Centre, Groton, CT 06340 | Physician/surgeon | 2020-08-01 ~ 2021-07-31 |
| Carrien Williams | 186 Mirra Dr, Groton, CT 06340 | Nail Technician | ~ |
| Mustapha Kemal Md | 61 Leeward Lane, Groton, CT 06340 | Physician/surgeon | 2020-07-01 ~ 2021-06-30 |
| Subway #309 | 967 Poquonnock Rd, Groton, CT 06340 | Bakery | 2020-07-01 ~ 2021-06-30 |
| Kathlene M Hunt | 75 Pleasant Street, Groton, CT 06340 | Notary Public Appointment | 2020-10-01 ~ 2025-09-30 |
| Paul A Morosky | 2 Cross Street, Groton, CT 06340 | Distribution System Operator - Class I | 2020-04-01 ~ 2023-03-31 |
| Find all Licenses in zip 06340 | |||
| City | Groton |
| Zip Code | 06340 |
| License Type | Physician/Surgeon |
| License Type + County | Physician/Surgeon + Groton |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Gilbert L Drozdow | Envision Physician Services, Plantation, FL 33322 | Physician/surgeon | 2019-10-01 ~ 2020-09-30 |
| Russell H Harris Md | Envision Physician Services, Horsham, PA 19044 | Physician/surgeon | 2019-09-01 ~ 2020-08-31 |
| Penny Lamhut Md | Genesis Physician Services, Windsor, CT 06098 | Physician/surgeon | 1999-07-15 ~ 2000-07-31 |
| John T Thompson | Physician Pavilion W, Towson, MD 21204 | Physician/surgeon | 2020-07-01 ~ 2021-06-30 |
| Arnold R Kriegstein | College Physician, New York, NY 10032 | Physician/surgeon | 1993-04-23 ~ 1994-03-31 |
| Catherine Nguyen Keegan | Envision Physician Services, Dallas, TX 75240 | Physician/surgeon | 2020-02-01 ~ 2021-01-31 |
| Brent Robert Jacobson | Envision Physician Services, Dallas, TX 75240 | Physician/surgeon | 2020-09-01 ~ 2021-08-31 |
| Nazanin Barzideh Md | North Shore Retina Physician, Pllc, East Hills, NY 11576 | Physician/surgeon | 2010-05-01 ~ 2011-04-30 |
| Susan J Batlan Md | Eye Physician Associates of Hartford, West Hartford, CT 06107 | Physician/surgeon | 2000-07-27 ~ 2001-07-31 |
| Sajot S Grewal Md | Danbury Office of Physician Services PC, Danbury, CT 06810 | Physician/surgeon | 2004-01-30 ~ 2005-03-31 |
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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).