JENNIFER A THEOHARIS (Credential# 563366) is licensed (Physician/surgeon) with Connecticut Department of Consumer Protection. The license effective date is June 1, 2013. The license expiration date date is May 31, 2014. The license status is INACTIVE.
JENNIFER A THEOHARIS is licensed with the Department of Consumer Protection of Connecticut. The credential number is #1.045784. The credential type is physician/surgeon. The effective date is June 1, 2013. The expiration date is May 31, 2014. The business address is 11995 Singletree Lane, Eden Prairie, MN 55344. The current status is inactive.
| Licensee Name | JENNIFER A THEOHARIS |
| Credential ID | 563366 |
| Credential Number | 1.045784 |
| Credential Type | Physician/Surgeon |
| Business Address |
11995 Singletree Lane Eden Prairie MN 55344 |
| Business Type | INDIVIDUAL |
| Status | INACTIVE - LAPSED DUE TO NON-RENEWAL |
| Issue Date | 2007-08-15 |
| Effective Date | 2013-06-01 |
| Expiration Date | 2014-05-31 |
| Refresh Date | 2014-09-09 |
| Street Address | 11995 Singletree Lane |
| City | Eden Prairie |
| State | MN |
| Zip Code | 55344 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Donald T Nicell | 11995 Singletree Lane, Eden Prairie, MN 55344 | Physician/surgeon | 2020-08-01 ~ 2021-07-31 |
| Alan J Kopp | 11995 Singletree Lane, Eden Prairie, MN 55344 | Physician/surgeon | 2020-08-01 ~ 2021-07-31 |
| Jennifer Kim Md | 11995 Singletree Lane, Eden Prairie, MN 55344 | Physician/surgeon | 2020-08-01 ~ 2021-07-31 |
| Joseph Michael Rozell | 11995 Singletree Lane, Eden Prairie, MN 55344 | Physician/surgeon | 2020-07-01 ~ 2021-06-30 |
| Jeffrey Brian Cutler | 11995 Singletree Lane, Eden Prairie, MN 55344 | Physician/surgeon | 2020-06-01 ~ 2021-05-31 |
| Wendy Elaine Zimmer | 11995 Singletree Lane, Eden Prairie, MN 55344 | Physician/surgeon | 2020-06-01 ~ 2021-05-31 |
| Richard T. Kaplan | 11995 Singletree Lane, Eden Prairie, MN 55344 | Physician/surgeon | 2020-06-01 ~ 2021-05-31 |
| Kevin Charles Wright | 11995 Singletree Lane, Eden Prairie, MN 55344 | Physician/surgeon | 2020-05-01 ~ 2021-04-30 |
| Raymond Bozman | 11995 Singletree Lane, Eden Prairie, MN 55344 | Physician/surgeon | 2020-04-01 ~ 2021-03-31 |
| Christopher M. Garcia | 11995 Singletree Lane, Eden Prairie, MN 55344 | Physician/surgeon | 2020-04-01 ~ 2021-03-31 |
| Find all Licenses in the same address | |||
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Neuroone Medical Technologies Corp | 7599 Anagram Dr, Eden Prairie, MN 55344 | Securities - Exemptions | 2020-05-15 ~ |
| Robert Edward Stone | 11995 Singletree Lane, Ste 500, Eden Prairie, MN 55344 | Physician/surgeon | 2020-07-01 ~ 2021-06-30 |
| Daniel James Tangert | 6400 Fallbrook Rd., Eden Prairie, MN 55344 | Registered Nurse | 2020-05-01 ~ 2021-04-30 |
| Dmitry Bolkhovets | 11995 Singletree Ln, Eden Prairie, MN 55344 | Physician/surgeon | 2020-05-01 ~ 2021-04-30 |
| Zinpro | 104000 Vikings Drive, Suite 240, Eden Prairie, MN 55344 | Commercial Feed | 2020-03-05 ~ 2020-12-31 |
| Michael Wallace Sentome | 11995 Singletree Lane, Suite 500, Eden Prairie, MN 55344 | Physician/surgeon | 2020-05-01 ~ 2021-04-30 |
| Stephanie Denise Johnson | 8423 Cortland Rd, Eden Prairie, MN 55344 | Registered Nurse | 2020-06-01 ~ 2021-05-31 |
| Ashley Nicole Ingram | 11000 Optum Circle, Eden Prairie, MN 55344 | Registered Nurse | 2020-01-16 ~ 2020-08-31 |
| Colleen M Steven | 13900 Chestnut Drive # 208, Eden Prarie, MN 55344 | Registered Nurse | 2019-12-01 ~ 2020-11-30 |
| Rebecca Dipofi Rogers | 13625 Technology Dr, Eden Prairie, MN 55344 | Registered Nurse | 2019-09-01 ~ 2020-08-31 |
| Find all Licenses in zip 55344 | |||
| City | Eden Prairie |
| Zip Code | 55344 |
| License Type | Physician/Surgeon |
| License Type + County | Physician/Surgeon + Eden Prairie |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Constantine G Theoharis | 849 Jennifers Drive, Guilford, CT 06437 | Physician/surgeon | 2012-07-01 ~ 2013-06-30 |
| Jennifer R Lee Md | 85 Viscount Dr#8c, Milford, CT 06460 | Physician/surgeon | 2018-06-01 ~ 2019-05-31 |
| Jennifer H. Kuo | 161 Fort Washington Ave Fl 8, New York, NY 10032-3729 | Physician/surgeon | ~ |
| Jennifer L Yeh Md | 4 Smith Dr, Savannah, GA 31406-6441 | Physician/surgeon | 2012-12-01 ~ 2013-11-30 |
| Jennifer L Bau | 1 Guthrie Sq, Sayre, PA 18840-1625 | Physician/surgeon | 2017-03-01 ~ 2018-02-28 |
| Jennifer Lax Md | 23 Old Stone Bridge Rd, Cos Cob, CT 06807-1511 | Physician/surgeon | 2003-05-16 ~ 2004-02-29 |
| Jennifer P Hsu Md | 1690 Dixwell Ave., Apt 29, Hamden, CT 06514 | Physician/surgeon | 2010-12-01 ~ 2011-11-30 |
| Jennifer K Fan Md | Advanced Radiology, Shelton, CT 06484 | Physician/surgeon | 2020-01-01 ~ 2020-12-31 |
| Jennifer F Cross | 19 W Brookside Dr, Larchmont, NY 10538 | Physician/surgeon | 1992-03-24 ~ 1993-02-28 |
| Jennifer B Gruen | 323 Riverside Ave, Westport, CT 06880-4810 | Physician/surgeon | 2020-03-01 ~ 2021-02-28 |
Please comment or provide details below to improve the information on JENNIFER A THEOHARIS.
| 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).