TERESA DOMACK (Credential# 1488244) is licensed (Resident Physician) with Connecticut Department of Consumer Protection. The license effective date is June 23, 2014. The license expiration date date is September 9, 2018. The license status is INACTIVE.
TERESA DOMACK is licensed with the Department of Consumer Protection of Connecticut. The credential number is #1.057661-RES. The credential type is resident physician. The effective date is June 23, 2014. The expiration date is September 9, 2018. The business address is 90 South Main St., Middletown, CT 06457. The current status is inactive.
| Licensee Name | TERESA DOMACK |
| Credential ID | 1488244 |
| Credential Number | 1.057661-RES |
| Credential Type | Resident Physician |
| Credential SubCategory | RES |
| Business Address |
90 South Main St. Middletown CT 06457 |
| Business Type | INDIVIDUAL |
| Status | INACTIVE - INACTIVE |
| Issue Date | 2014-06-23 |
| Effective Date | 2014-06-23 |
| Expiration Date | 2018-09-09 |
| Refresh Date | 2018-09-10 |
| Street Address | 90 South Main St. |
| City | Middletown |
| State | CT |
| Zip Code | 06457 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Alexandra Stanford | 90 South Main St., Middletown, CT 06457 | Resident Physician | 2019-06-24 ~ 2023-07-02 |
| Joshua Jones | 90 South Main St., Middletown, CT 06457 | Resident Physician | 2019-06-24 ~ 2023-07-02 |
| Arti Bhukhen | 90 South Main St., Middletown, CT 06457 | Resident Physician | 2019-06-24 ~ 2023-07-02 |
| Gianpaolo Rufo | 90 South Main St., Middletown, CT 06457 | Resident Physician | 2019-06-24 ~ 2023-07-02 |
| Sona Sadselia-patel | 90 South Main St., Middletown, CT 06457 | Resident Physician | 2019-06-24 ~ 2023-07-02 |
| Kalpana Reddy | 90 South Main St., Middletown, CT 06457 | Resident Physician | 2019-06-24 ~ 2023-07-02 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Elizabeth M Mailhot | 177 Timber Ridge Rd, Middletown, CT 06457 | Dental Hygienist | 2020-08-01 ~ 2021-07-31 |
| Rebecca S Fennessy | 22 Keefe Ln, Middletown, CT 06457 | Licensed Clinical Social Worker | 2020-07-01 ~ 2021-06-30 |
| Eloise M Gagnon | 538 Bow Lane, Middletown, CT 06457 | Hairdresser/cosmetician | 2020-08-01 ~ 2022-07-31 |
| Salvatore Dimauro | 245 Dekoven Dr, Middletown, CT 06457 | Public Weigher | 2020-07-01 ~ 2021-06-30 |
| Frank L Wright | 261 Spencer Dr, Middletown, CT 06457 | Barber | 2020-08-01 ~ 2022-07-31 |
| Gino A Cardella | 50 Sonoma Lane, Middletown, CT 06457 | Real Estate Salesperson | ~ |
| Shannon Lee Mcquillan | 5 Forest Glen Circle, Middletown, CT 06457 | Registered Nurse | 2020-06-26 ~ 2020-09-30 |
| Lori Dimauro · Carta | 244 Chamberlain Hill Road, Middletown, CT 06457 | Hairdresser/cosmetician | 2020-09-01 ~ 2022-08-31 |
| Gail A Corrow | 85 Dora Dr, Middletown, CT 06457 | Real Estate Salesperson | 2020-06-01 ~ 2021-05-31 |
| Mariter V Perez | 8 Moss Glen, Middletown, CT 06457 | Registered Nurse | 2020-08-01 ~ 2021-07-31 |
| Find all Licenses in zip 06457 | |||
| City | Middletown |
| Zip Code | 06457 |
| License Type | Resident Physician |
| License Type + County | Resident Physician + Middletown |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Douglas Domack · Domack Roofing & Siding | 7 Fiddlehead Rd, Oxford, CT 06478-2708 | Home Improvement Contractor | 2000-12-01 ~ 2001-02-27 |
| Teresa Maria Domack | 79 Bayberry Hill Rd, Avon, CT 06001-2800 | Controlled Substance Registration for Practitioner | 2019-01-02 ~ 2021-02-28 |
| Teresa M Domack | 79 Bayberry Hill Road, Avon, CT 06001 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Domack Roofing LLC | 185 Charles St, Stratford, CT 06615-6708 | Home Improvement Contractor | 2019-12-01 ~ 2020-11-30 |
| Domack Associates LLC | 7 Fiddlehead Rd, Oxford, CT 06478-2708 | Home Improvement Contractor | 2017-12-01 ~ 2018-11-30 |
| Domack Restoration LLC | 185 Charles St, Stratford, CT 06615-6708 | Major Contractor | 2020-07-01 ~ 2021-06-30 |
| Maria Teresa Peralta Espejo | 263 Farmington Ave, Farmington, CT 06030-0001 | Resident Physician | 2020-06-28 ~ 2023-06-30 |
| Teresa Da Cunha | 263 Farmington Ave, Farmington, CT 06030-0001 | Resident Physician | 2019-06-28 ~ 2022-06-30 |
| Domack Restoration LLC | CT | Asbestos Contractor | ~ |
| Elizabeth A Domack | 18 Rimmon Rd, Woodbridge, CT 06525-2002 | Professional Counselor | 2020-03-01 ~ 2021-02-28 |
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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).