KIRT FREDERICKSON MD (Credential# 557973) 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.
KIRT FREDERICKSON MD is licensed with the Department of Consumer Protection of Connecticut. The credential number is #1.040390. The credential type is physician/surgeon. The effective date is June 1, 2020. The expiration date is May 31, 2021. The business address is 24 Hospital Ave, Danbury, CT 06810. The current status is active.
| Licensee Name | KIRT FREDERICKSON MD |
| Credential ID | 557973 |
| Credential Number | 1.040390 |
| Credential Type | Physician/Surgeon |
| Business Address |
24 Hospital Ave Danbury CT 06810 |
| Business Type | INDIVIDUAL |
| Status | ACTIVE - CURRENT |
| Active | 1 |
| Issue Date | 2002-05-01 |
| Effective Date | 2020-06-01 |
| Expiration Date | 2021-05-31 |
| Refresh Date | 2020-05-18 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 311705 | CSP.0032237 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 2002-05-28 | 2019-03-01 - 2021-02-28 | ACTIVE |
| Street Address | 24 HOSPITAL AVE |
| City | DANBURY |
| State | CT |
| Zip Code | 06810 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Lauren Drake | 24 Hospital Ave, Danbury, CT 06810-6099 | Resident Physician | 2020-06-22 ~ 2026-06-30 |
| Patra Childress | 24 Hospital Ave, Danbury, CT 06810-6099 | Resident Physician | 2020-06-22 ~ 2026-06-30 |
| Karri Hester | 24 Hospital Ave, Danbury, CT 06810-6099 | Resident Physician | 2020-07-01 ~ 2026-06-30 |
| Mary Winslow | 24 Hospital Ave, Danbury, CT 06810-6099 | Resident Physician | 2020-06-22 ~ 2026-06-30 |
| Minha Kim | 24 Hospital Ave, Danbury, CT 06810-6099 | Resident Physician | 2018-06-21 ~ 2025-06-30 |
| Arash Rahimi-ardabily | 24 Hospital Ave, Danbury, CT 06810-6099 | Resident Physician | 2019-06-20 ~ 2025-06-30 |
| Krist Aploks | 24 Hospital Ave, Danbury, CT 06810-6099 | Resident Physician | 2019-06-20 ~ 2025-06-30 |
| Cynthia Mckinney | 24 Hospital Ave, Danbury, CT 06810-6099 | Resident Physician | 2020-07-01 ~ 2024-06-30 |
| Amanda Ferraro | 24 Hospital Ave, Danbury, CT 06810-6099 | Resident Physician | 2020-06-22 ~ 2024-06-30 |
| Anya Laibangyang | 24 Hospital Ave, Danbury, CT 06810-6099 | Resident Physician | 2020-06-22 ~ 2024-06-30 |
| Find all Licenses in the same address | |||
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Eastern College Athletic Conference Inc | Matrix Corp Ctr 39 Old Ridgebury Rd, Danbury, CT 06810 | Public Charity | 2019-06-01 ~ 2020-05-31 |
| Subway #36533 | 67 Newtown Rd, Danbury, CT 06810 | Bakery | 2020-07-01 ~ 2021-06-30 |
| Natali Salome Teran | 27 Balmforth Ave 2, Danbury, CT 06810 | Combination Nail Technician, Esthetician Or Eyelash Technici | 2020-06-27 ~ 2022-06-30 |
| Kristin Danielle Mehta | 33 Country View Road, Danbury, CT 06810 | Advanced Practice Registered Nurse | 2020-07-01 ~ 2021-06-30 |
| Zhane Gabrielle Cardenas | 40 Westville Avenue Apt 1, Danbury, CT 06810 | Nail Technician | 2020-06-27 ~ 2021-09-30 |
| Zhane E Willikinson | 30 Germantown Road Suite 117, Danbury, CT 06810 | Nail Technician | 2020-06-27 ~ 2022-03-31 |
| Michelle Dahlgren | 8 Stable Drive, Danbury, CT 06810 | Combination Nail Technician, Esthetician Or Eyelash Technici | ~ |
| Asheree P Griffin | 14 New Town Road, Danbury, CT 06810 | Real Estate Salesperson | ~ |
| Tania Isabel Salazar | 20 Highland Avenue, Danbury, CT 06810 | Combination Nail Technician, Esthetician Or Eyelash Technici | 2020-06-26 ~ 2022-05-31 |
| Gregory C Banks | Gregory Banks Counseling, LLC, Danbury, CT 06810 | Professional Counselor | 2020-08-01 ~ 2021-07-31 |
| Find all Licenses in zip 06810 | |||
| City | DANBURY |
| Zip Code | 06810 |
| License Type | Physician/Surgeon |
| License Type + County | Physician/Surgeon + DANBURY |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Howard I Frederickson IIi · Frederickson Farm | 985 Chopmist Hill Rd, Scituate, RI 02857-1045 | Home Improvement Contractor | 2019-12-01 ~ 2020-11-30 |
| Steven R Frederickson | 272 Salem St, Lynnfield, MA 01940 | Professional Engineer | 2020-02-01 ~ 2021-01-31 |
| Shannon L Frederickson | 97 Hickory St, West Haven, CT 06516-5618 | Registered Nurse | 2020-05-01 ~ 2021-04-30 |
| Dana Gestal Frederickson | 87 Myrtle Avenue, Westport, CT 06880 | Professional Counselor | ~ |
| Angela S Rogers | 34 Frederickson Ave, Holden, MA 01520-1730 | Real Estate Broker | 2020-04-01 ~ 2021-03-31 |
| Leslee A Frederickson | 1 Spruce Ter, Wayne, NJ 07470-4350 | Licensed Practical Nurse | 2017-11-01 ~ 2018-10-31 |
| Leslee Frederickson | 100 Hillside Avenue, Shelton, CT 06484 | Emergency Medical Technician | ~ 1995-04-01 |
| Kirt J Rasmussen | 10 Sable Ct # 67, Unionville, CT 06085 | Real Estate Salesperson | 2007-06-01 ~ 2008-05-31 |
| Kirt L Ervin | 13742 Mary Ln, Aviston, IL 62216-4733 | Professional Engineer | 2018-02-01 ~ 2019-01-31 |
| Kirt P Olmstead | 349 Center St, Wolcott, CT 06716 | Sub-surface Sewage Installer | 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).