DERIK L DAVIS (Credential# 912561) is licensed (Physician/surgeon) with Connecticut Department of Consumer Protection. The license effective date is September 1, 2019. The license expiration date date is August 31, 2020. The license status is ACTIVE.
DERIK L DAVIS is licensed with the Department of Consumer Protection of Connecticut. The credential number is #1.048594. The credential type is physician/surgeon. The effective date is September 1, 2019. The expiration date is August 31, 2020. The business address is 4082 Fragile Sail Way, Ellicott City, MD 21042-5018. The current status is active.
| Licensee Name | DERIK L DAVIS |
| Credential ID | 912561 |
| Credential Number | 1.048594 |
| Credential Type | Physician/Surgeon |
| Business Address |
4082 Fragile Sail Way Ellicott City MD 21042-5018 |
| Business Type | INDIVIDUAL |
| Status | ACTIVE - CURRENT |
| Active | 1 |
| Issue Date | 2010-03-30 |
| Effective Date | 2019-09-01 |
| Expiration Date | 2020-08-31 |
| Refresh Date | 2019-08-22 |
| Street Address | 4082 FRAGILE SAIL WAY |
| City | ELLICOTT CITY |
| State | MD |
| Zip Code | 21042-5018 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Marilyn L Koza | 2280 Ballard Way, Ellicott City, MD 21042 | Registered Nurse | 2020-07-01 ~ 2021-06-30 |
| Rebecca A Bunnell | 4610 Learned Sage, Ellicott City, MD 21042 | Physician Assistant | 2020-04-01 ~ 2021-03-31 |
| Sara Case | 9359 Duff Court, Ellicott City, MD 21042 | Registered Nurse | 2020-02-27 ~ 2020-12-31 |
| Jason P Bashura | 3114 Ramblewood Rd, Ellicott City, MD 21042 | Registered Sanitarian | 2020-01-01 ~ 2020-12-31 |
| Mahalingam Balakrishnan | 9909 Carrigan Drive, Ellicott City, MD 21042 | Professional Engineer | 2020-02-01 ~ 2021-01-31 |
| Grace Yeon Son | 3809 Portman Place, Ellicott City, MD 21042 | Speech and Language Pathologist | ~ |
| Heather K Dull | 4269 Buckskinwood Dr, Ellicott City, MD 21042 | Real Estate Salesperson | 2007-06-01 ~ 2008-05-31 |
| Michael J Steinberg | 4760 Leyden Way, Ellicott City, MD 21042 | Pharmacist | 2014-02-01 ~ 2016-01-31 |
| William H Allen | 10310 Cromwell Ct, Ellicott City, MD 21042 | Professional Engineer | 1997-07-02 ~ 1998-01-31 |
| Manol Andonyadis | 4747 Hallowed Stream, Ellicott City, MD 21042 | Professional Engineer | 1800-12-27 ~ 1994-01-31 |
| Find all Licenses in zip 21042 | |||
| City | ELLICOTT CITY |
| Zip Code | 21042 |
| License Type | Physician/Surgeon |
| License Type + County | Physician/Surgeon + ELLICOTT CITY |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Derik K. King | 4075 Copper Ridge Dr, Traverse City, MI 49684-7059 | Physician/surgeon | 2019-10-01 ~ 2020-09-30 |
| Mark Davis | Po Box 222, Abingdon, MD 21009-0222 | Physician/surgeon | ~ |
| Davis C Chu | 28-49 Corporal, Bayside, NY 11360 | Physician/surgeon | 2003-07-23 ~ 2004-08-31 |
| Davis Liu | 150 Spear St Ste 350, San Francisco, CA 94105-1747 | Physician/surgeon | 2020-03-01 ~ 2021-02-28 |
| Rima T Aouad Md | 22 Davis Rd, Woodbridge, CT 06525-2426 | Physician/surgeon | 2020-03-01 ~ 2021-02-28 |
| Brian James Davis | 200 First Street Sw, Rochester, MN 55905 | Physician/surgeon | ~ |
| James A Davis | Po Box 476, Cross River, NY 10518 | Physician/surgeon | 2008-11-26 ~ 2009-12-31 |
| Allen F Davis Md | 164 Mt. Pleasant Rd., Newtown, CT 06470 | Physician/surgeon | 2020-03-01 ~ 2021-02-28 |
| Francis P Alcedo Md | 7 Davis Rd, Woodbridge, CT 06525 | Physician/surgeon | 2020-05-01 ~ 2021-04-30 |
| Vinod V Pathy | 5 Davis Rd E, Old Lyme, CT 06371-1413 | Physician/surgeon | 2020-03-01 ~ 2021-02-28 |
Please comment or provide details below to improve the information on DERIK L DAVIS.
| 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).