JAY GOLDBERG MD (Credential# 555710) is licensed (Physician/surgeon) with Connecticut Department of Consumer Protection. The license effective date is September 8, 1999. The license expiration date date is September 30, 2000. The license status is INACTIVE.
JAY GOLDBERG MD is licensed with the Department of Consumer Protection of Connecticut. The credential number is #1.038120. The credential type is physician/surgeon. The effective date is September 8, 1999. The expiration date is September 30, 2000. The business address is 12615 North East 6th Street, Bellevue, WA 98005. The current status is inactive.
| Licensee Name | JAY GOLDBERG MD |
| Credential ID | 555710 |
| Credential Number | 1.038120 |
| Credential Type | Physician/Surgeon |
| Business Address |
12615 North East 6th Street Bellevue WA 98005 |
| Business Type | INDIVIDUAL |
| Status | INACTIVE - LAPSED DUE TO NON-RENEWAL |
| Issue Date | 1999-09-08 |
| Effective Date | 1999-09-08 |
| Expiration Date | 2000-09-30 |
| Refresh Date | 2009-07-11 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 221848 | CSP.0028779 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 1999-09-17 - 2000-02-28 | INACTIVE |
| Street Address | 12615 NORTH EAST 6TH STREET |
| City | BELLEVUE |
| State | WA |
| Zip Code | 98005 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Kevy Wijaya | 1570 134th Ave Se, Bellevue, WA 98005 | Registered Nurse | 2020-02-01 ~ 2021-01-31 |
| Brian J Unsderfer | 13228 Ne 20th St#100, Bellevue, WA 98005 | Professional Engineer | 2020-02-01 ~ 2021-01-31 |
| Hope Heart Institute (the) | 606 120th Ave Ne S D103, Bellevue, WA 98005 | Public Charity | 2016-12-01 ~ 2017-08-07 |
| Microsoft Alumni Network Giving Foundation | 12708 Northup Way #303, Bellevue, WA 98005 | Public Charity | 2008-05-19 ~ 2008-05-31 |
| Trinidad R Bustria | 2050 132nd Ave Se, Bellevue, WA 98005 | Registered Nurse | 1998-05-08 ~ 1999-06-30 |
| Kathryn A Neilson | 13775 Ne 34th Place, Bellevue, WA 98005 | Physician/surgeon | 1992-10-23 ~ 1993-12-31 |
| Karen J Wilson | 2840 139th Avenue S E, Bellevue, WA 98005 | Advanced Practice Registered Nurse | 1999-04-19 ~ 2000-05-31 |
| Fauzia Hussain | 12211 Northeast 5th Street, Bellevue, WA 98005 | Pharmacist | 2001-03-23 ~ 2002-01-31 |
| Drugstore.com | 13920 Southeast Eastgate Way, Bellvue, WA 98005 | Nonresident Pharmacy | 2005-06-06 ~ 2005-08-31 |
| Wineworth LLC | 1500 127th Avenue Se, Bellevue, WA 98005 | Out of State Shipper Liquor | 2006-10-25 ~ 2007-10-24 |
| Find all Licenses in zip 98005 | |||
| City | BELLEVUE |
| Zip Code | 98005 |
| License Type | Physician/Surgeon |
| License Type + County | Physician/Surgeon + BELLEVUE |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Jeffrey R Goldberg Md | 25 Collins Rd, Bristol, CT 06010 | Physician/surgeon | 2020-06-01 ~ 2021-05-31 |
| Jana Goldberg | 156 W. 56th Street, New York, NY 08033 | Physician/surgeon | ~ |
| Barry Goldberg Md | 17 Hillhouse Ave, New Haven, CT 06520 | Physician/surgeon | 2006-11-03 ~ 2007-12-31 |
| Richard N Goldberg | 8 Woodland Ln, Berlin, CT 06037-1130 | Physician/surgeon | 2013-05-01 ~ 2013-08-04 |
| Sarah B Goldberg | 333 Cedar St, Fmp 130, New Haven, CT 06510-3206 | Physician/surgeon | 2020-09-01 ~ 2021-08-31 |
| Marc Goldberg Md | 605 West Ave, Norwalk, CT 06850 | Physician/surgeon | 1996-05-24 ~ 1997-05-31 |
| Sheldon S Goldberg | 2 Medical Ctr Dr, Springfield, MA 01107 | Physician/surgeon | 1993-06-24 ~ 1994-08-31 |
| Heidi E Goldberg | P.o.box 7578, Seminole, FL 33775-7578 | Physician/surgeon | 2006-02-23 ~ 2007-03-31 |
| David J Goldberg Md | 87 Linden St, New Haven, CT 06511 | Physician/surgeon | 2005-03-03 ~ 2006-03-31 |
| Arnold R. Goldberg | 61 Brook Rd, Sharon, MA 02067-1415 | Physician/surgeon | 1984-05-01 ~ 1985-05-31 |
Please comment or provide details below to improve the information on JAY GOLDBERG 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).