KERRY S RUSSELL (Credential# 556497) is licensed (Physician/surgeon) with Connecticut Department of Consumer Protection. The license effective date is June 1, 2020. The license expiration date date is May 31, 2021. The license status is ACTIVE.
KERRY S RUSSELL is licensed with the Department of Consumer Protection of Connecticut. The credential number is #1.038909. The credential type is physician/surgeon. The effective date is June 1, 2020. The expiration date is May 31, 2021. The business address is 103 Fox Rd Unit 612, Waltham, MA 02451-0206. The current status is active.
| Licensee Name | KERRY S RUSSELL |
| Credential ID | 556497 |
| Credential Number | 1.038909 |
| Credential Type | Physician/Surgeon |
| Business Address |
103 Fox Rd Unit 612 Waltham MA 02451-0206 |
| Business Type | INDIVIDUAL |
| Status | ACTIVE - CURRENT |
| Active | 1 |
| Issue Date | 2000-08-01 |
| Effective Date | 2020-06-01 |
| Expiration Date | 2021-05-31 |
| Refresh Date | 2020-03-25 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 242809 | CSP.0029960 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 2000-08-14 | 2017-03-01 - 2019-02-28 | LAPSED |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Kerry S Russell · Yale University School of Medicine | 789 Howard Ave, New Haven, CT 06519-1304 | Controlled Substance Laboratory | 2013-02-26 ~ 2014-01-31 |
| Street Address | 103 FOX RD UNIT 612 |
| City | WALTHAM |
| State | MA |
| Zip Code | 02451-0206 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| William T Whitlock | 681 Main Street Ste 3-31, Waltham, MA 02451 | Architect | 2020-08-01 ~ 2021-07-31 |
| Surgi-care Inc | 71 1 St Ave, Waltham, MA 02451 | Wholesaler of Drugs, Cosmetics & Medical Devices | 2020-07-01 ~ 2021-06-30 |
| Dsf Multi-family Fund - 2019, L.p. | 950 Winter St, Ste 4300, Waltham, MA 02451 | Securities - Exemptions | 2020-04-17 ~ |
| Colleen K Dietter | 67 Black Bear Drive # 1512, Waltham, MA 02451 | Notary Public Appointment | 2015-02-01 ~ 2020-01-31 |
| Qeepsake, Inc. | 200 5th Avenue, Waltham, MA 02451 | Securities - Exemptions | 2020-03-05 ~ |
| 3decor LLC | 281 Winter Street, Waltham, MA 02451 | Importer of Bedding & Upholstered Furniture | 2020-05-01 ~ 2021-04-30 |
| Peach Innovations, Inc. | 204 Second Avenue, Waltham, MA 02451 | Securities - Exemptions | 2020-03-03 ~ |
| Simpson Gumpertz & Heger Associates Inc | 480 Totten Pond Road, Waltham, MA 02451 | Joint Practice | 2020-05-01 ~ 2021-04-30 |
| Omotola O T'sarumi | 507 Stearns Hill Rd, Waltham, MA 02451 | Physician/surgeon | 2020-04-01 ~ 2021-03-31 |
| Derek B Mccowan | 101 Pond End Road, Waltham, MA 02451 | Professional Engineer | 2020-02-01 ~ 2021-01-31 |
| Find all Licenses in zip 02451 | |||
| City | WALTHAM |
| Zip Code | 02451 |
| License Type | Physician/Surgeon |
| License Type + County | Physician/Surgeon + WALTHAM |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Russell F Turk Md | Stamford Health Russell Turk, Md, Riverside, CT 06878 | Physician/surgeon | 2020-03-01 ~ 2021-02-28 |
| Kerry Cooper | Metabolism Assoc, New Haven, CT 06511 | Physician/surgeon | 2000-03-22 ~ 2001-04-30 |
| Jason Naidich | 15 Kerry Lane, Darien, CT 06820 | Physician/surgeon | 2020-01-01 ~ 2020-12-31 |
| Kerry E Wright | 567 Wormwood Road, Fairfield, CT 06824 | Physician/surgeon | 2020-03-01 ~ 2021-02-28 |
| Kerry K Ford | 341 Tenth Avenue, Royersford, PA 19468 | Physician/surgeon | 2010-10-01 ~ 2011-09-30 |
| Kerry Williams Eley | 3033 Campus Dr Ste W225, Plymouth, MN 55441-2651 | Physician/surgeon | ~ |
| Russell H Harris Md | Envision Physician Services, Horsham, PA 19044 | Physician/surgeon | 2019-09-01 ~ 2020-08-31 |
| Russell W Robertson | Po Box 234, Dublin, NH 03444-0234 | Physician/surgeon | 2012-12-01 ~ 2013-11-30 |
| Douglas R. Mailly | 119 Russell St, Cornwall, NY 12518-1711 | Physician/surgeon | ~ |
| Raymond R Russell IIi | 333 Cedar St # 3, New Haven, CT 06510-3206 | Physician/surgeon | 2017-06-01 ~ 2018-05-31 |
Please comment or provide details below to improve the information on KERRY S RUSSELL.
| 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).