LESLIE D. DOUGLAS-CHURCHWELL (Credential# 1323164) 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.
LESLIE D. DOUGLAS-CHURCHWELL is licensed with the Department of Consumer Protection of Connecticut. The credential number is #1.055309. The credential type is physician/surgeon. The effective date is July 1, 2020. The expiration date is June 30, 2021. The business address is 21 Mill Rd, Guilford, CT 06437-2414. The current status is active.
| Licensee Name | LESLIE D. DOUGLAS-CHURCHWELL |
| Credential ID | 1323164 |
| Credential Number | 1.055309 |
| Credential Type | Physician/Surgeon |
| Business Address |
21 Mill Rd Guilford CT 06437-2414 |
| Business Type | INDIVIDUAL |
| Status | ACTIVE - CURRENT |
| Active | 1 |
| Issue Date | 2016-06-01 |
| Effective Date | 2020-07-01 |
| Expiration Date | 2021-06-30 |
| Refresh Date | 2020-06-16 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 1360385 | CSP.0063131 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 2016-06-14 | 2019-03-01 - 2021-02-28 | ACTIVE |
| Street Address | 21 MILL RD |
| City | GUILFORD |
| State | CT |
| Zip Code | 06437-2414 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Bailey Building and Excavating LLC | 21 Mill Rd, Guilford, CT 06437 | Home Improvement Contractor | 2011-12-01 ~ 2012-11-30 |
| Bailey Excavating LLC | 21 Mill Rd, Guilford, CT 06437 | Home Improvement Contractor | 2004-12-01 ~ 2005-11-30 |
| Agnes Bailey | 21 Mill Rd, Guilford, CT 06437 | Real Estate Salesperson | ~ |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Jane E Olsen | Po Box 601, Guilford, CT 06437 | Real Estate Salesperson | 2020-06-27 ~ 2021-05-31 |
| Alanna Munzenmaier | 81 Saw Mill Rd, Guilford, CT 06437 | Veterinarian | 2020-07-01 ~ 2021-06-30 |
| Sandra L Lion | 84 Granite Road, Guilford, CT 06437 | Notary Public Appointment | 2020-08-01 ~ 2025-07-31 |
| Nimet H Memik-moavero | 110 Cherry Street, Guilford, CT 06437 | Real Estate Salesperson | ~ |
| Jacklyn Nicole Basilicato | 345 Saw Mill Road, Guilford, CT 06437 | Registered Nurse | 2020-07-01 ~ 2021-06-30 |
| Alissa Bailey | 5 Streamview Circle, Guilford, CT 06437 | Notary Public Appointment | 2020-09-01 ~ 2025-08-31 |
| The Marketplace Emporia LLC · The Marketplace Emporia, LLC | 77-79 Whitfield Street, Guilford, CT 06437 | Bakery | 2020-07-01 ~ 2021-06-30 |
| Deborah Ackles | 46clear Lake Manor Road, Guilford, CT 06437 | Veterinarian | 2020-08-01 ~ 2021-07-31 |
| Bruce D Mccann | 200 State St, Guilford, CT 06437 | Architect | 2020-08-01 ~ 2021-07-31 |
| Stephanie J Jacobs | 130 Winthrop Rd, Guilford, CT 06437 | Real Estate Salesperson | 2020-06-25 ~ 2021-05-31 |
| Find all Licenses in zip 06437 | |||
| City | GUILFORD |
| Zip Code | 06437 |
| License Type | Physician/Surgeon |
| License Type + County | Physician/Surgeon + GUILFORD |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Leslie Coopersmith | 133 Scovill St. Ste. 101, Waterbury, CA 06706 | Physician/surgeon | ~ |
| Leslie J Drake | 56 Wells St, Westerly, RI 02891 | Physician/surgeon | 1997-12-22 ~ 1999-02-28 |
| Leslie M Israel | 8 Cerrito, Irvine, CA 92612 | Physician/surgeon | 2015-04-01 ~ 2016-03-31 |
| Leslie R Miller Do | 52 Beach Rd Ste 102, Fairfield, CT 06824-6017 | Physician/surgeon | 2020-03-01 ~ 2021-02-28 |
| Leslie A. Oleksowicz | 11 Maywood Dr, Old Lyme, CT 06371-1544 | Physician/surgeon | 2014-04-01 ~ 2015-03-31 |
| Leslie C Huff | 258 Main St Ste 208, Milford, MA 01757-2506 | Physician/surgeon | 2019-12-01 ~ 2020-11-30 |
| Leslie Donovan Md | 159 W Putnam Ave, Greenwich, CT 06830-5329 | Physician/surgeon | 2020-07-01 ~ 2021-06-30 |
| Leslie Hsiung | 701 5th Ave Ste 2300, Seattle, WA 98104 | Physician/surgeon | 2019-12-01 ~ 2020-11-30 |
| Leslie P Beal Md | 40 Oakridge, Unionville, CT 06085-1472 | Physician/surgeon | 2019-04-01 ~ 2020-03-31 |
| Leslie M. Rickey | 25 Alston Ave, New Haven, CT 06515-2702 | Physician/surgeon | 2020-06-01 ~ 2021-05-31 |
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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).