NATALIE A WALLACE (Credential# 1491040) is licensed (Resident Physician) with Connecticut Department of Consumer Protection. The license effective date is July 21, 2017. The license expiration date date is June 30, 2021. The license status is ACTIVE.
NATALIE A WALLACE is licensed with the Department of Consumer Protection of Connecticut. The credential number is #1.059142-RES. The credential type is resident physician. The effective date is July 21, 2017. The expiration date is June 30, 2021. The business address is 30 Huntington Rd, New Haven, CT 06512-2627. The current status is active.
| Licensee Name | NATALIE A WALLACE |
| Credential ID | 1491040 |
| Credential Number | 1.059142-RES |
| Credential Type | Resident Physician |
| Credential SubCategory | RES |
| Business Address |
30 Huntington Rd New Haven CT 06512-2627 |
| Business Type | INDIVIDUAL |
| Status | ACTIVE - CURRENT |
| Active | 1 |
| Issue Date | 2017-07-21 |
| Effective Date | 2017-07-21 |
| Expiration Date | 2021-06-30 |
| Refresh Date | 2020-05-27 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 1229971 | CSP.0057500 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 2014-06-23 | 2015-03-01 - 2017-02-28 | INACTIVE |
| Street Address | 30 HUNTINGTON RD |
| City | NEW HAVEN |
| State | CT |
| Zip Code | 06512-2627 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Nicholas J Pini | 24 Huntington Rd, New Haven, CT 06512-2627 | Heating, Piping & Cooling Unlimited Journeyperson | 2019-09-29 ~ 2020-08-31 |
| Mark R Misbach II | 16 Huntington Rd, New Haven, CT 06512-2627 | Emergency Medical Technician | 2017-01-13 ~ 2020-10-01 |
| Edin Portilla | 36 Huntington Rd, New Haven, CT 06512-2627 | Asbestos Abatement Supervisor | 2018-02-05 ~ 2018-09-30 |
| Mayelin Virtudes Jimenez | 24 Huntington Rd, New Haven, CT 06512-2627 | Licensed Practical Nurse | ~ |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| East Haven Police Union Local #1662 | Po Box 120033, East Haven, CT 06512 | Public Charity | 2019-06-01 ~ 2020-05-31 |
| Danielle M Verderame | 66 Maple Street, East Haven, CT 06512 | Registered Nurse | 2020-07-01 ~ 2021-06-30 |
| Judith M Lyon · Sousa | 440 Townsend Ave, New Haven, CT 06512 | Registered Nurse | 2020-09-01 ~ 2021-08-31 |
| Toni Louise Montuori | 44 Francis St, East Haven, CT 06512 | Radiographer | 2020-07-01 ~ 2021-06-30 |
| Marcos E Zambrano | 17 Morse Place, New Haven, CT 06512 | Real Estate Salesperson | ~ |
| Nha H Lam | 274 Chidsey Ave, East Haven, CT 06512 | Combination Nail Technician, Esthetician Or Eyelash Technici | 2020-06-26 ~ 2021-07-31 |
| Niraliben N Patel | 44 Columbus Ave, East Haven, CT 06512 | Esthetician | ~ |
| Alyssa C Zordan | 65 Francis Street, East Haven, CT 06512 | Registered Nurse | 2020-09-01 ~ 2021-08-31 |
| Gomes Cleaning & Painting LLC | 296 Burr St, New Haven, CT 06512 | Home Improvement Contractor | 2020-06-18 ~ 2020-11-30 |
| Keith Bouve · Residential Restorations | 99 Prospect Rd, East Haven, CT 06512 | Home Improvement Contractor | 2020-06-24 ~ 2020-11-30 |
| Find all Licenses in zip 06512 | |||
| City | NEW HAVEN |
| Zip Code | 06512 |
| License Type | Resident Physician |
| License Type + County | Resident Physician + NEW HAVEN |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Natalie A Pozzi | 56 Franklin St, Waterbury, CT 06706-1253 | Resident Physician | 2019-07-01 ~ 2021-06-30 |
| Levy Wallace | 50 Davenport Ave Apt 3m, New Rochelle, NY 10805 | Resident Physician | 2020-07-01 ~ 2023-06-30 |
| Natalie J Patel | 45 Garden Dr # B, Elmwood Park, NJ 07407-1016 | Resident Physician | 2018-08-08 ~ 2021-06-30 |
| Natalie Anne Mackow | 20 York St, New Haven, CT 06510-3220 | Resident Physician | 2020-07-01 ~ 2021-06-30 |
| Natalie Godfrey | 263 Farmington Ave, Farmington, CT 06030-1921 | Resident Physician | 2018-08-13 ~ 2018-08-24 |
| Natalie M Wallace | 124 Coalpit Hill Rd, Danbury, CT 06810-8021 | Master's Level Social Worker | 2019-09-01 ~ 2020-08-31 |
| Natalie H Wallace | Yale-new Haven Hospital, New Haven, CT 06510 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Wallace Company Inc · C Robert Wallace | 28 N Main St, W Hartford, CT 06107-1928 | Real Estate Broker | 2001-04-01 ~ 2002-03-31 |
| Richard W Wallace · Dick Wallace & Son Builders Inc | Po Box 3672, Groton Long Point, CT 06340-1608 | Home Improvement Contractor | 1995-06-02 ~ 1996-11-30 |
| John R Wallace | 130 Washington St Apt 6, Norwich, CT 06360 | Home Improvement Contractor | ~ 1995-05-01 |
Please comment or provide details below to improve the information on NATALIE A WALLACE.
| 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).