THEODORE D SPIVACK DMD (Credential# 699380) is licensed (Dentist) with Connecticut Department of Consumer Protection. The license effective date is October 1, 2015. The license expiration date date is September 30, 2016. The license status is INACTIVE.
THEODORE D SPIVACK DMD is licensed with the Department of Consumer Protection of Connecticut. The credential number is #2.001778. The credential type is dentist. The effective date is October 1, 2015. The expiration date is September 30, 2016. The business address is 172 Meadowmere Rd, Stratford, CT 06614-1625. The current status is inactive.
| Licensee Name | THEODORE D SPIVACK DMD |
| Credential ID | 699380 |
| Credential Number | 2.001778 |
| Credential Type | Dentist |
| Business Address |
172 Meadowmere Rd Stratford CT 06614-1625 |
| Business Type | INDIVIDUAL |
| Status | INACTIVE - LAPSED DUE TO NON-RENEWAL |
| Issue Date | 1901-01-01 |
| Effective Date | 2015-10-01 |
| Expiration Date | 2016-09-30 |
| Refresh Date | 2016-08-15 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 146995 | CSP.0001277 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 2013-03-01 - 2015-02-28 | INACTIVE |
| Street Address | 172 MEADOWMERE RD |
| City | STRATFORD |
| State | CT |
| Zip Code | 06614-1625 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Pumpkin Patch Day Care | 144 Meadowmere Rd, Stratford, CT 06614-1625 | Group Child Care Home | 2018-08-01 ~ 2022-07-31 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Nicole Marie Minaudo | 80 Barrows Ter, Stratford, CT 06614 | Registered Nurse | 2020-09-01 ~ 2021-08-31 |
| Constance Greene | 65 Pamela Drive, Stratford, CT 06614 | Registered Nurse | 2020-08-01 ~ 2021-07-31 |
| Courtney M Blaze | 90 Mercer Street, Stratford, CT 06614 | Massage Therapist | 2020-07-01 ~ 2022-06-30 |
| William E Rosner Md | 81 B Seminole Lane, Stratford, CT 06614 | Physician/surgeon | 2020-07-01 ~ 2021-06-30 |
| Demetrius I Mcqueen | 60 Emerald Pl, Stratford, CT 06614 | Real Estate Salesperson | 2020-06-26 ~ 2021-05-31 |
| Alan Goldberg | 1825 Barnum Ave, Stratford, CT 06614 | Dentist | 2020-09-01 ~ 2021-08-31 |
| Kimberly L Matakevich | 1367 Nichols Avenue, Stratford, CT 06614 | Licensed Practical Nurse | 2020-09-01 ~ 2021-08-31 |
| Marybeth Nemergut | 990 Chapel St, Stratford, CT 06614 | Registered Nurse | 2020-08-01 ~ 2021-07-31 |
| Geraldine C Corry | 135 Wigwam Lane, Stratford, CT 06614 | Real Estate Salesperson | 2020-06-01 ~ 2021-05-31 |
| Kathleen Sajgovic | 300 Post Oak Rd, Stratford, CT 06614 | Registered Nurse | 2020-08-01 ~ 2021-07-31 |
| Find all Licenses in zip 06614 | |||
| City | STRATFORD |
| Zip Code | 06614 |
| License Type | Dentist |
| License Type + County | Dentist + STRATFORD |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Theodore J Gargano | 26 Wood Rd, Branford, CT 06405-4936 | Dentist | 2020-05-01 ~ 2021-04-30 |
| Theodore Lenczyk | Po Box 11447, Newington, CT 06111 | Dentist | 1994-09-19 ~ 1995-08-31 |
| Theodore R Hillhouse | 24 Griswold Point, Old Lyme, CT 06371 | Dentist | 1994-09-08 ~ 1995-11-30 |
| Theodore W Zdeblick | 51 North Main St, Southington, CT 06489 | Dentist | 2020-04-01 ~ 2021-03-31 |
| Theodore K Wu Dmd | 65 Memorial Rd Suite 400, West Hartford, CT 06107 | Dentist | 2020-07-01 ~ 2021-06-30 |
| Theodore J Pappas Dds | 1 Riverview Street, Enfield, CT 06082 | Dentist | 2020-05-01 ~ 2021-04-30 |
| Christopher J Curley | 12 Theodore Roosevelt Dr, Blauvelt, NY 10913-1717 | Dentist | 2012-03-01 ~ 2013-02-28 |
| Theodore A Niebloom | 17 Birchwood Drive, Livingston, NJ 07039 | Dentist | 1992-06-25 ~ 1993-05-31 |
| Theodore J Zervas Dmd | 7 Park Place, Middletown, CT 06457 | Dentist | 2019-10-01 ~ 2020-09-30 |
| Theodore E Splaver | 5500 N. Military Trail Apt. 274, Boca Raton, FL 33496-3406 | Dentist | 2018-01-01 ~ 2018-12-31 |
Please comment or provide details below to improve the information on THEODORE D SPIVACK DMD.
| 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).