ANDREA L BENIN MD (Credential# 557101) is licensed (Physician/surgeon) with Connecticut Department of Consumer Protection. The license effective date is March 1, 2020. The license expiration date date is February 28, 2021. The license status is ACTIVE.
ANDREA L BENIN MD is licensed with the Department of Consumer Protection of Connecticut. The credential number is #1.039516. The credential type is physician/surgeon. The effective date is March 1, 2020. The expiration date is February 28, 2021. The business address is 117 Kirk Crossing Dr, Decatur, GA 30030-3773. The current status is active.
Licensee Name | ANDREA L BENIN MD |
Credential ID | 557101 |
Credential Number | 1.039516 |
Credential Type | Physician/Surgeon |
Business Address |
117 Kirk Crossing Dr Decatur GA 30030-3773 |
Business Type | INDIVIDUAL |
Status | ACTIVE - CURRENT |
Active | 1 |
Issue Date | 2001-05-09 |
Effective Date | 2020-03-01 |
Expiration Date | 2021-02-28 |
Refresh Date | 2020-01-30 |
ID | Credential Code | Credential Type | Issue | Term | Status |
---|---|---|---|---|---|
431989 | CSP.0038921 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 2006-03-15 | 2019-03-01 - 2021-02-28 | ACTIVE |
Street Address | 117 KIRK CROSSING DR |
City | DECATUR |
State | GA |
Zip Code | 30030-3773 |
Licensee Name | Office Address | Credential | Effective / Expiration |
---|---|---|---|
Mark D Oprisch | 413 Mimosa Dr, Decatur, GA 30030 | Architect | 2020-08-01 ~ 2021-07-31 |
Philip D Rhodes | 222 Willow Ln, Decatur, GA 30030 | Professional Engineer | 2020-02-01 ~ 2021-01-31 |
Randall S Booker Jr | 114 Heatherdown Road, Decatur, GA 30030 | Professional Engineer | 2020-02-01 ~ 2021-01-31 |
Nikulkumar R Chaudhari | 790 Grove Bend, Decatur, GA 30030 | Physician/surgeon | 2020-01-01 ~ 2020-12-31 |
David C Purselle | 250 E. Ponce De Leon Ave Ste 800, Atlanta, GA 30030 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
United Methodist Children's Home | 500 S. Columbia Drive, Decatur, GA 30030 | Public Charity-exempt From Financial Requirements | ~ |
Joseph M Gottardy | 208 Michigan Ave, Decatur, GA 30030 | Professional Engineer | 2015-02-01 ~ 2016-01-31 |
Kelly A Hightower | 1375 Thomas Rd, Decatur, GA 30030 | Registered Nurse | 2011-10-01 ~ 2012-09-30 |
George Gerard Voith | 2507 Mckinnon Dr, Decatur, GA 30030 | Architect | 2005-08-01 ~ 2006-07-31 |
Nancy C Anderson | 218 E Trinity Place, Decatur, GA 30030 | Registered Nurse | 2004-12-30 ~ 2006-02-28 |
Find all Licenses in zip 30030 |
City | DECATUR |
Zip Code | 30030 |
License Type | Physician/Surgeon |
License Type + County | Physician/Surgeon + DECATUR |
Licensee Name | Office Address | Credential | Effective / Expiration |
---|---|---|---|
Andrea Vidali | 41 S 5th St Apt 11, Brooklyn, NY 11249-8417 | Physician/surgeon | ~ |
Wen-ray T Hsu | 18 Andrea Lane, Scarsdale, NY 10583 | Physician/surgeon | 2007-12-19 ~ 2008-10-31 |
Andrea C Lin | 9 N Gate Rd, Carmel, NY 10512-2213 | Physician/surgeon | 2010-09-09 ~ 2011-06-30 |
Andrea L Lundell | 105 Liberty Ln, Rockwall, TX 75032-8462 | Physician/surgeon | 2017-06-01 ~ 2018-05-31 |
Andrea G Asnes | 324 Yale Ave, New Haven, CT 06515-2233 | Physician/surgeon | 2019-10-01 ~ 2020-09-30 |
Andrea J Rock | 30 Lyon St # 3, New Haven, CT 06511-4926 | Physician/surgeon | 2012-06-01 ~ 2013-05-31 |
Andrea B Lese | 301 Central Ave Ne, Albuquerque, NM 87102-3885 | Physician/surgeon | 2015-10-01 ~ 2016-09-30 |
Carl C D'andrea Md | 10 Pilgrim's Way, Gaylordsville, CT 06755 | Physician/surgeon | 2020-04-01 ~ 2021-03-31 |
Andrea J Needleman | 4 So Pomperaug Ave, Woodbury, CT 06798 | Physician/surgeon | 2020-06-01 ~ 2021-05-31 |
Dana Salomy | 24 Andrea Ln, Scarsdale, NY 10583-3116 | Physician/surgeon | 2019-08-01 ~ 2020-07-31 |
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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).