MARK D WATSON MD (Credential# 564032) is licensed (Physician/surgeon) with Connecticut Department of Consumer Protection. The license effective date is July 1, 2020. The license expiration date date is June 30, 2021. The license status is ACTIVE.
MARK D WATSON MD is licensed with the Department of Consumer Protection of Connecticut. The credential number is #1.046450. The credential type is physician/surgeon. The effective date is July 1, 2020. The expiration date is June 30, 2021. The business address is 15 Riverside Ave, Bristol, CT 06010. The current status is active.
| Licensee Name | MARK D WATSON MD |
| Credential ID | 564032 |
| Credential Number | 1.046450 |
| Credential Type | Physician/Surgeon |
| Business Address |
15 Riverside Ave Bristol CT 06010 |
| Business Type | INDIVIDUAL |
| Status | ACTIVE - CURRENT |
| Active | 1 |
| Issue Date | 2008-04-23 |
| Effective Date | 2020-07-01 |
| Expiration Date | 2021-06-30 |
| Refresh Date | 2020-04-24 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 502242 | CSP.0043491 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 2008-05-12 | 2019-03-01 - 2021-02-28 | ACTIVE |
| Street Address | 15 Riverside Ave |
| City | BRISTOL |
| State | CT |
| Zip Code | 06010 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Liran Blum | 15 Riverside Ave, Bristol, CT 06010-6951 | Physician/surgeon | 2020-06-01 ~ 2021-05-31 |
| Cara Pittari | 15 Riverside Ave, Bristol, CT 06010 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Alexandra R Vitale | 15 Riverside Ave, Bristol, CT 06010-5161 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Deborah M Dube · Adamaitis | 33 Peck Lane, Bristol, CT 06010 | Licensed Practical Nurse | 2020-07-01 ~ 2021-06-30 |
| Barbara M Williams | 45 Harrison Street, Bristol, CT 06010 | Notary Public Appointment | 2020-08-01 ~ 2025-07-31 |
| Le Bao Linh Nguyen | 229 Silo Rd, Bristol, CT 06010 | Nail Technician | ~ |
| Tara M Chipman | 38 Grove St, Bristol, CT 06010 | Licensed Practical Nurse | 2020-07-01 ~ 2021-06-30 |
| Jaclyn J Brandolini | 424 Emmett St, Bristol, CT 06010 | Registered Nurse | 2020-07-01 ~ 2021-06-30 |
| Hoa Le | 63 Seminary St, Bristol, CT 06010 | Nail Technician | ~ |
| Barbara E Trench | 25 Peacedale St, Bristol, CT 06010 | Hairdresser/cosmetician | 2020-07-01 ~ 2022-06-30 |
| Tisha A Balfour | 379 West Street, Bristol, CT 06010 | Licensed Practical Nurse | 2020-08-01 ~ 2021-07-31 |
| Meredith Rose Martineau | 15 Bishop Street, Bristol, CT 06010 | Master's Level Social Worker - Temporary Permit | 2020-06-26 ~ 2020-09-06 |
| Jaime L Krueger | 130 Garfield Road, Bristol, CT 06010 | Notary Public Appointment | 2020-06-26 ~ 2025-06-30 |
| Find all Licenses in zip 06010 | |||
| City | BRISTOL |
| Zip Code | 06010 |
| License Type | Physician/Surgeon |
| License Type + County | Physician/Surgeon + BRISTOL |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| John Watson Cochran | 328 Front St S, La Crosse, WI 54601-4023 | Physician/surgeon | ~ |
| Kevin W Watson | 300 Kensington Ave, New Britain, CT 06051-3916 | Physician/surgeon | 2020-06-01 ~ 2021-05-31 |
| Steven J Green | 36 Watson St, Willimantic, CT 06226 | Physician/surgeon | 2020-06-01 ~ 2021-05-31 |
| Stephen M Rouse | 36 Watson St, Willimantic, CT 06226 | Physician/surgeon | 2020-06-01 ~ 2021-05-31 |
| Collin C Watson Md | 12 Beckett Ave, Branford, CT 06405 | Physician/surgeon | 2020-04-01 ~ 2021-03-31 |
| Samuel D Kao | C/o H Kirk Watson, Hartford, CT 06106 | Physician/surgeon | 1994-02-23 ~ 1995-04-30 |
| Elizabeth J Watson | 60 Forbes Avenue, Northampton, MA 01060 | Physician/surgeon | 2016-08-01 ~ 2017-07-31 |
| Sherif Ibrahim | 200 Watson Blvd, Stratford, CT 06615 | Physician/surgeon | 2019-01-01 ~ 2019-12-31 |
| Kelley T Watson Md | 120 Meadowbrook Drive, Greenwood, SC 29649 | Physician/surgeon | 2012-03-01 ~ 2013-02-28 |
| James E Watson Md | 87 Ballamahack Road, Windham, CT 06280 | Physician/surgeon | 2016-01-01 ~ 2016-12-31 |
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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).