CLARK S HOMAN (Credential# 555787) is licensed (Physician/surgeon) with Connecticut Department of Consumer Protection. The license effective date is September 24, 2007. The license expiration date date is October 31, 2008. The license status is PENDING.
CLARK S HOMAN is licensed with the Department of Consumer Protection of Connecticut. The credential number is #1.038197. The credential type is physician/surgeon. The effective date is September 24, 2007. The expiration date is October 31, 2008. The business address is 2 Pagnotta Drive, Port Jefferson, NY 11776. The current status is pending.
| Licensee Name | CLARK S HOMAN |
| Credential ID | 555787 |
| Credential Number | 1.038197 |
| Credential Type | Physician/Surgeon |
| Business Address |
2 Pagnotta Drive Port Jefferson NY 11776 |
| Business Type | INDIVIDUAL |
| Status | PENDING - REINSTATEMENT APPLICATION PENDING |
| Issue Date | 1999-10-15 |
| Effective Date | 2007-09-24 |
| Expiration Date | 2008-10-31 |
| Refresh Date | 2016-11-04 |
| Street Address | 2 Pagnotta Drive |
| City | Port Jefferson |
| State | NY |
| Zip Code | 11776 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Joanne Louise Downing | 7 Cully Street, Port Jefferson Station, NY 11776 | Physical Therapist | 2020-04-01 ~ 2021-03-31 |
| Beth Anne Travis | 307 Woodhull Ave, Port Jefferson Station, NY 11776 | Registered Nurse - Temporary | 2020-04-22 ~ 2020-08-20 |
| Kelly Ann Kosciuk | 5 Hancock Street, Port Jefferson Station, NY 11776 | Registered Nurse | 2020-03-06 ~ 2021-02-28 |
| Praimchand Nardeo | 15a East Grove Street, Port Jefferson Station, NY 11776 | Tax Preparer/facilitator Permit | 2020-02-11 ~ 2022-02-28 |
| Paul Lappano | 45 Bedford Ave, Port Jefferson Station, NY 11776 | Professional Engineer | 2020-02-01 ~ 2021-01-31 |
| Stewart D Charaton | 3 Exeter Drive, Port Jefferson Station, NY 11776 | Notary Public Appointment | 2005-12-28 ~ 2010-12-31 |
| Jeffrey Lee Vacirca | 1500 Route 112 Building 4, Port Jefferson Station, NY 11776 | Physician/surgeon | 2020-02-01 ~ 2021-01-31 |
| Kristen Youngberg | 1 Evelyn Rd, Port Jeff Sta, NY 11776 | Massage Therapist | 2018-09-19 ~ 2020-09-30 |
| Paul Alan Werfel | 36 Sahenandoah Avlvd, Port Jefferson Station, NY 11776 | Emergency Medical Technician | ~ |
| Michael Allen Hawley | 36 South Columbia St., Port Jefferson Station, NY 11776 | Master's Level Social Worker | ~ |
| Find all Licenses in zip 11776 | |||
| City | Port Jefferson |
| Zip Code | 11776 |
| License Type | Physician/Surgeon |
| License Type + County | Physician/Surgeon + Port Jefferson |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Ann O Massion Md | 157 Clark St, Worcester, MA 01606 | Physician/surgeon | 2002-04-16 ~ 2003-05-31 |
| Matthew S Clark | Po Box 129, Montrose, NY 10548-0129 | Physician/surgeon | 2019-12-01 ~ 2020-11-30 |
| R S Briggs Md | 138 Clark Rd, Litchfield, CT 06759 | Physician/surgeon | 2006-12-21 ~ 2007-12-31 |
| Denise Clark | 1 North Ln, Albany, NY 12211-1629 | Physician/surgeon | 2020-08-01 ~ 2021-07-31 |
| Clark E O'brien | P.o. Box 722, West Simsbury, CT 06092 | Physician/surgeon | 2018-11-01 ~ 2019-10-31 |
| Brian J Clark | 1 Caleb Ct, Guilford, CT 06437-2298 | Physician/surgeon | 2020-07-01 ~ 2021-06-30 |
| Antonio Scappaticci Md | 625 Clark Ave, Bristol, CT 06010 | Physician/surgeon | 2020-09-01 ~ 2021-08-31 |
| Leo P Clark | 3812 Windward Dr., Sylvania, OH 43560 | Physician/surgeon | 2020-06-01 ~ 2021-05-31 |
| Carolyn Jones Md | 36 Clark Ln, Waterford, CT 06385 | Physician/surgeon | 2004-01-12 ~ 2005-02-28 |
| Michael H Clark | P.o.box 1291, Goldsboro, NC 27533 | Physician/surgeon | 1999-08-19 ~ 2000-08-31 |
Please comment or provide details below to improve the information on CLARK S HOMAN.
| 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).