MARK S GODFREY (Credential# 1490712) is licensed (Resident Physician) 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.
MARK S GODFREY is licensed with the Department of Consumer Protection of Connecticut. The credential number is #1.058814-RES. The credential type is resident physician. The effective date is July 1, 2020. The expiration date is June 30, 2021. The business address is 300 Cedar St Tac S425, New Haven, CT 06519-1612. The current status is active.
| Licensee Name | MARK S GODFREY |
| Credential ID | 1490712 |
| Credential Number | 1.058814-RES |
| Credential Type | Resident Physician |
| Credential SubCategory | RES |
| Business Address |
300 Cedar St Tac S425 New Haven CT 06519-1612 |
| Business Type | INDIVIDUAL |
| Status | ACTIVE - CURRENT |
| Active | 1 |
| Issue Date | 2017-07-01 |
| Effective Date | 2020-07-01 |
| Expiration Date | 2021-06-30 |
| Refresh Date | 2020-05-12 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 1411231 | CSP.0064982 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 2017-08-08 | 2019-03-01 - 2021-02-28 | ACTIVE |
| Street Address | 300 CEDAR ST TAC S425 |
| City | NEW HAVEN |
| State | CT |
| Zip Code | 06519-1612 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Alexander Robert Ghincea | 300 Cedar St Tac S425, New Haven, CT 06519-1612 | Resident Physician | 2020-04-03 ~ 2021-06-30 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Elizabeth Sanchez Rangel | 300 Cedar St Ofc Of, New Haven, CT 06519-1612 | Physician/surgeon | 2020-06-16 ~ 2021-03-31 |
| Isabel Sofia Bazan | Yale-new Haven Medical Center - P.o Box 208057, New Haven, CT 06519-1612 | Physician/surgeon | 2020-08-01 ~ 2021-07-31 |
| Lenore M Buckley | 300 Cedar St, New Haven, CT 06519-1612 | Physician/surgeon | 2020-09-01 ~ 2021-08-31 |
| Zachary Lipkin-moore | 300 Cedar St # 441, New Haven, CT 06519-1612 | Resident Physician | 2017-07-01 ~ 2021-06-30 |
| Zachary Michael Harris | 300 Cedar St Tac S-425, New Haven, CT 06519-1612 | Resident Physician | 2017-07-01 ~ 2021-06-30 |
| Brinda Emu | 300 Cedar St Tac S169, New Haven, CT 06519-1612 | Physician/surgeon | 2020-05-01 ~ 2021-04-30 |
| Cristina M Brunet Md | 300 Cedar St # S541, New Haven, CT 06519-1612 | Physician/surgeon | 2020-07-01 ~ 2021-06-30 |
| Janice Hwang | 1 Gilbert St, New Haven, CT 06519-1612 | Controlled Substance Laboratory | 2020-02-01 ~ 2021-01-31 |
| Andrew Wang | 1 Gilbert Street., New Haven, CT 06519-1612 | Controlled Substance Laboratory | 2020-02-26 ~ 2021-01-31 |
| Richard Lifton · Yale University School of Medicine | 300 Cedar St # Tac-s-340, New Haven, CT 06519-1612 | Controlled Substance Laboratory | 2020-02-01 ~ 2021-01-31 |
| Find all Licenses in zip 06519-1612 | |||
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Vinod H Srihari Md | 34 Park St Cmhc, New Haven, CT 06519 | Physician/surgeon | 2020-09-01 ~ 2021-08-31 |
| Monica Brito Salinas | 111 Kimberly Ave., New Haven, CT 06519 | Combination Nail Technician, Esthetician Or Eyelash Technici | 2020-06-27 ~ 2022-02-28 |
| Walter Mathis | 34 Park St., New Haven, CT 06519 | Physician/surgeon | 2020-07-01 ~ 2021-06-30 |
| Kimberly Pizza · Emmanuel Zorgias | 34 Kimberly Ave, New Haven, CT 06519 | Bakery | 2020-07-01 ~ 2021-06-30 |
| Slawomir Piascik | 51 Longhini Lane, New Haven, CT 06519 | Asbestos Abatement Supervisor | 2020-08-01 ~ 2021-07-31 |
| Margaret T Boron | 428 Columbus Ave, New Haven, CT 06519 | Physician/surgeon | 2020-07-01 ~ 2021-06-30 |
| Laura Ann Dicola | Connecticut Mental Health Center Law & Psychiatry, New Haven, CT 06519 | Physician/surgeon | 2020-07-01 ~ 2021-06-30 |
| Elizabeth Parson | 689 Congress Ave, New Haven, CT 06519 | Medication Administration Certification | 2020-08-05 ~ 2022-08-04 |
| Alejandra Lopez Cervantes | 10 Hedge St, New Haven, CT 06519 | Combination Nail Technician, Esthetician Or Eyelash Technici | 2020-06-20 ~ 2021-08-31 |
| Deicy Alexandra Urena Dagua | 267 Howard Ave, New Haven, CT 06519 | Combination Nail Technician, Esthetician Or Eyelash Technici | 2020-06-20 ~ 2021-10-31 |
| Find all Licenses in zip 06519 | |||
| City | NEW HAVEN |
| Zip Code | 06519 |
| License Type | Resident Physician |
| License Type + County | Resident Physician + NEW HAVEN |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Mark Spencer Godfrey | 15 York St, New Haven, CT 06510-3221 | Physician/surgeon | 2020-06-02 ~ 2021-09-30 |
| Natalie Godfrey | 263 Farmington Ave, Farmington, CT 06030-1921 | Resident Physician | 2018-08-13 ~ 2018-08-24 |
| Mark Benedict | 117 Shore Dr Apt 2, Branford, CT 06405-4858 | Resident Physician | 2017-07-01 ~ 2021-06-30 |
| Mark Steven Mcfarland | 267 Grant St, Bridgeport, CT 06610-2805 | Resident Physician | 2018-07-01 ~ 2023-06-30 |
| Jason Mark Beckta | 20 York St, New Haven, CT 06510-3220 | Resident Physician | 2020-07-01 ~ 2021-06-30 |
| Mark Mikhitarian | 750 Summer Street #403, Norwalk, CT 06850 | Resident Physician | 2017-06-19 ~ 2018-06-18 |
| Justin Mark Le Blanc | 62 Toledo Ave, Warwick, RI 02888-4133 | Resident Physician | 2020-07-01 ~ 2021-06-30 |
| Mark Archer Eckardt | 20 York St. Tompkins 2, Room 226, New Haven, CT 06510-3220 | Resident Physician | 2020-06-22 ~ 2021-06-30 |
| Mark E Godfrey | 51 Christie Way Apt 51b, Marlborough, MA 01752 | Professional Engineer | 2016-02-01 ~ 2017-01-31 |
| Mark E Godfrey | 776 Farmington Ave, West Hartford, CT 06119-1677 | Chiropractor | 2018-08-01 ~ 2020-07-31 |
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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).