CHARLES E CLARK (Credential# 679315) is licensed (Advanced Practice Registered Nurse) with Connecticut Department of Consumer Protection. The license effective date is November 24, 1997. The license expiration date date is December 31, 1998. The license status is INACTIVE.
CHARLES E CLARK is licensed with the Department of Consumer Protection of Connecticut. The credential number is #12.001135. The credential type is advanced practice registered nurse. The effective date is November 24, 1997. The expiration date is December 31, 1998. The business address is 5422 Diamond Street, Philadelphia, PA 19131. The current status is inactive.
| Licensee Name | CHARLES E CLARK |
| Credential ID | 679315 |
| Credential Number | 12.001135 |
| Credential Type | Advanced Practice Registered Nurse |
| Business Address |
5422 Diamond Street Philadelphia PA 19131 |
| Business Type | INDIVIDUAL |
| Status | INACTIVE - LAPSED DUE TO NON-RENEWAL |
| Issue Date | 1995-05-26 |
| Effective Date | 1997-11-24 |
| Expiration Date | 1998-12-31 |
| Refresh Date | 2009-07-08 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 650813 | 10.R51067 | Registered Nurse | 1995-05-19 | 1995-11-01 - 1996-12-31 | INACTIVE |
| Street Address | 5422 DIAMOND STREET |
| City | PHILADELPHIA |
| State | PA |
| Zip Code | 19131 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Yossel Sarahi Velasquez Ferrufino | 3900 City Avenue, Philadelphia, PA 19131 | Registered Nurse | 2020-02-01 ~ 2021-01-31 |
| Joseph R Martin Md | 3900 City Ave, Philadelphia, PA 19131 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Philadelphia College of Osteopathic Medicine Foundation | 4170 City Ave, Philadelphia, PA 19131 | Public Charity-exempt From Financial Requirements | 2016-08-01 ~ |
| Joyce A Harrell | 1533 N. 55th St., Philadelphia, PA 19131 | Radiographer | 2008-12-10 ~ 2010-01-31 |
| West Park Imports Inc | 3960 Lankenau Avenue, Philadelphia, PA 19131 | Out of State Shipper Liquor | 2008-03-05 ~ 2009-03-04 |
| Ellen M Martin Gemme · Gemme | 4040-1907, Philadelphia, PA 19131 | Registered Nurse | 1995-06-05 ~ 1996-05-31 |
| Frederick A Nunes | 6100 City Ave, Philadelphia, PA 19131 | Physician/surgeon | 1996-03-18 ~ 1997-05-31 |
| Mario J Poon | 3901 Conshohocken, Philadelphia, PA 19131 | Physician/surgeon | 1993-04-23 ~ 1994-06-30 |
| Barbara P Jordan | 2122 North 50th St, Philadelphia, PA 19131 | Registered Nurse | 2005-07-05 ~ 2006-08-31 |
| Marilyn C Campbell | 4000 Presidential Blvd. Apt. 1006, Philadelphia, PA 19131 | Registered Nurse | 2007-03-28 ~ 2008-03-31 |
| Find all Licenses in zip 19131 | |||
| City | PHILADELPHIA |
| Zip Code | 19131 |
| License Type | Advanced Practice Registered Nurse |
| License Type + County | Advanced Practice Registered Nurse + PHILADELPHIA |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Elizabeth T Sweeney | 617 Clark St, South Windsor, CT 06074-3609 | Advanced Practice Registered Nurse | 2020-09-01 ~ 2021-08-31 |
| Kolu Stephanie Baysah Clark | 149 Pomona Ave, Providence, RI 02908-5123 | Advanced Practice Registered Nurse | ~ |
| Pamela L Driscoll | One Charles St, Boston, MA 02116 | Advanced Practice Registered Nurse | 2010-03-01 ~ 2011-02-28 |
| Charles D Mills | 51 Glenn Drive, Warwick, RI 02886 | Advanced Practice Registered Nurse | ~ 1996-06-30 |
| Charles Newton Mullican | 1 Cityplace Dr Ste 570, Saint Louis, MO 63141-7067 | Advanced Practice Registered Nurse | 2019-11-05 ~ 2020-11-30 |
| Charles K Gowen | 13 Reed Hill Road, Granby, CT 06035 | Advanced Practice Registered Nurse | 2015-02-01 ~ 2016-01-31 |
| Lesley Nicole Charles | 275 Mary Ellen Dr, Milford, CT 06460-6900 | Advanced Practice Registered Nurse | 2020-06-01 ~ 2021-05-31 |
| Charles Christopher Gerz | 7148 Atascadero Ln, Tallahassee, FL 32317-7460 | Advanced Practice Registered Nurse | 2020-03-16 ~ 2020-12-31 |
| Charles E Staples Jr | 205 Sylvan Lake Road, Oakville, CT 06779 | Advanced Practice Registered Nurse | 2020-03-01 ~ 2021-02-28 |
| Lynn E Pittsinger Aprn | 4701 Charles Place Apt 1522, Plano, TX 75093 | Advanced Practice Registered Nurse | 2006-05-25 ~ 2007-02-28 |
Please comment or provide details below to improve the information on CHARLES E CLARK.
| 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).