JOHN D KEITZ DO (Credential# 995702) is licensed (Controlled Substance Registration for Practitioner) with Connecticut Department of Consumer Protection. The license effective date is March 1, 2017. The license expiration date date is February 28, 2019. The license status is LAPSED.
JOHN D KEITZ DO is licensed with the Department of Consumer Protection of Connecticut. The credential number is #CSP.0050053. The credential type is controlled substance registration for practitioner. The effective date is March 1, 2017. The expiration date is February 28, 2019. The business address is 18 Enchanted Forest Dr, Bayfield, CO 81122-9753. The current status is lapsed.
| Licensee Name | JOHN D KEITZ DO |
| Credential ID | 995702 |
| Credential Number | CSP.0050053 |
| Credential Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| Business Address |
18 Enchanted Forest Dr Bayfield CO 81122-9753 |
| Business Type | INDIVIDUAL |
| Status | LAPSED |
| Active | 1 |
| Issue Date | 2011-06-10 |
| Effective Date | 2017-03-01 |
| Expiration Date | 2019-02-28 |
| Refresh Date | 2019-03-06 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 994639 | 1.049945-DO | Physician/Surgeon | 2011-06-08 | 2016-07-01 - 2017-06-30 | INACTIVE |
| Street Address | 18 ENCHANTED FOREST DR |
| City | BAYFIELD |
| State | CO |
| Zip Code | 81122-9753 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Melissa A Grenier | 399 North, Bayfield, CO 81122 | Hairdresser/cosmetician | 1996-05-28 ~ 1997-07-31 |
| John Sibley | 1107 Cr 502, Bayfield, CO 81122 | Electrical Unlimited Journeyperson | 2005-10-01 ~ 2006-09-30 |
| Bronwyn Kathleen Radcliffe | 355 County Road 503, Bayfield, CO 81122-9305 | Registered Nurse | 2019-12-10 ~ 2020-10-31 |
| City | BAYFIELD |
| Zip Code | 81122 |
| License Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| License Type + County | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER + BAYFIELD |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| John K John Md | 706f Doctors Drive, Kinston, NC 28501 | Controlled Substance Registration for Practitioner | 2001-03-01 ~ 2002-02-28 |
| John J Cho | 111 E 210th St, Bronx, NY 10467-2401 | Controlled Substance Registration for Practitioner | 2017-03-01 ~ 2019-02-28 |
| John M De Figueiredo | Po Box 573, Cheshire, CT 06410 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| John Delhagen Md | Po Box 772, Greenwich, CT 06836 | Controlled Substance Registration for Practitioner | 1999-03-01 ~ 2000-02-28 |
| John J Girald | Po Box 11, Newbury, NH 03255 | Controlled Substance Registration for Practitioner | 2015-03-01 ~ 2017-01-17 |
| John J. Dannon | Po Box 607, Canaan, CT 06018-0607 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| John P Kim Md | 25 Lajoie Ln, Milford, CT 06461-2411 | Controlled Substance Registration for Practitioner | 2013-03-01 ~ 2015-02-28 |
| John Lum | 4-6 Union Ave #20, Norwalk, CT 06851 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| John Fatse | 324 Elm St, Monroe, CT 06468 | Controlled Substance Registration for Practitioner | 2019-03-06 ~ 2021-02-28 |
| John N Utz | 197 Norwich-new, Uncasville, CT 06382 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
Please comment or provide details below to improve the information on JOHN D KEITZ DO.
| 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).