KEITH RAY HODGE MD (Credential# 556428) is licensed (Physician/surgeon) with Connecticut Department of Consumer Protection. The license effective date is March 12, 2001. The license expiration date date is March 31, 2002. The license status is INACTIVE.
KEITH RAY HODGE MD is licensed with the Department of Consumer Protection of Connecticut. The credential number is #1.038840. The credential type is physician/surgeon. The effective date is March 12, 2001. The expiration date is March 31, 2002. The business address is 95 Dover Rd, W Hartford, CT 06119. The current status is inactive.
| Licensee Name | KEITH RAY HODGE MD |
| Credential ID | 556428 |
| Credential Number | 1.038840 |
| Credential Type | Physician/Surgeon |
| Business Address |
95 Dover Rd W Hartford CT 06119 |
| Business Type | INDIVIDUAL |
| Status | INACTIVE - LAPSED DUE TO NON-RENEWAL |
| Issue Date | 2000-07-03 |
| Effective Date | 2001-03-12 |
| Expiration Date | 2002-03-31 |
| Refresh Date | 2009-07-11 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 237245 | CSP.0029776 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 2001-03-01 - 2002-02-28 | INACTIVE |
| Street Address | 95 DOVER RD |
| City | W HARTFORD |
| State | CT |
| Zip Code | 06119 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Danna Rae France | 1148 Boulevard, West Hartford, CT 06119 | Combination Nail Technician, Esthetician Or Eyelash Technici | 2020-06-27 ~ 2021-10-31 |
| Rayda R Bouma | 122 Richard St, West Hartford, CT 06119 | Registered Nurse | 2020-07-01 ~ 2021-06-30 |
| Norbert M Spencer | 17 Oakwood Ave., West Hartford, CT 06119 | Professional Counselor | 2020-07-01 ~ 2021-06-30 |
| Diedra A Dietter | 9 Birch Road, West Hartford, CT 06119 | Licensed Clinical Social Worker | 2020-07-01 ~ 2021-06-30 |
| Dahlia I Belnavis-bigenho · Belnavis | 186 Whiting Lane, West Hartford, CT 06119 | Respiratory Care Practitioner | 2020-08-01 ~ 2021-07-31 |
| Stephen R Dewey | 68 Richard St, W Hartford, CT 06119 | Architect | 2020-08-01 ~ 2021-07-31 |
| James E Vance Jr | 9 Plymouth Rd, W Hartford, CT 06119 | Architect | 2020-08-01 ~ 2021-07-31 |
| Mark D Hirsch | 105 Griswold Dr, W Hartford, CT 06119 | Architect | 2020-08-01 ~ 2021-07-31 |
| Judith Briggs | 29 Troy St, West Hartford, CT 06119 | Registered Nurse | 2020-07-01 ~ 2021-06-30 |
| Thulan P Vu | 74 Park Road, West Hartford, CT 06119 | Nail Technician | 2020-06-24 ~ 2022-06-30 |
| Find all Licenses in zip 06119 | |||
| City | W HARTFORD |
| Zip Code | 06119 |
| License Type | Physician/Surgeon |
| License Type + County | Physician/Surgeon + W HARTFORD |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Daniel Hodge | Ste 224, Saint Louis, MO 63108 | Physician/surgeon | 2020-03-18 ~ 2020-10-31 |
| William F Hodge Md | 407 Brand Street, North Vancouver, BC V7N4G4 | Physician/surgeon | 2013-03-01 ~ 2014-02-28 |
| Keith C Boldon Md | Keith Boldon Md, Cheshire, CT 06410 | Physician/surgeon | 2020-03-01 ~ 2021-02-28 |
| Keith L Hodge | 120 Lake St, Ephrata, PA 17522-2415 | Professional Engineer | 2020-02-01 ~ 2021-01-31 |
| Keith A Hernandez Md | 193 River Rd, Madison, CT 06443 | Physician/surgeon | 2020-06-01 ~ 2021-05-31 |
| Keith B Quencer | 198 Edwards St Apt 4, New Haven, CT 06511-3702 | Physician/surgeon | 2017-11-01 ~ 2018-10-31 |
| Keith M Spellman | Po Box 320757, Los Gatos, CA 95032-0112 | Physician/surgeon | 2018-09-01 ~ 2019-08-31 |
| Keith Edwards | 140 Hospital Dr, Bennington, VT 05201 | Physician/surgeon | 1992-07-23 ~ 1993-06-30 |
| Keith A Cauley | 33 Fairview Dr, Farmington, CT 06032-2516 | Physician/surgeon | 2020-01-24 ~ 2020-08-31 |
| Keith A Kaplan | 24 Carriage Dr, Farmington, CT 06032-2704 | Physician/surgeon | 2020-04-01 ~ 2021-03-31 |
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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).