SAMUEL CLARKE (Credential# 1510734) is licensed (Physician/surgeon) with Connecticut Department of Consumer Protection. The license effective date is August 1, 2020. The license expiration date date is July 31, 2021. The license status is ACTIVE.
SAMUEL CLARKE is licensed with the Department of Consumer Protection of Connecticut. The credential number is #1.061754. The credential type is physician/surgeon. The effective date is August 1, 2020. The expiration date is July 31, 2021. The business address is 20 York St Tompkins 226, New Haven, CT 06510-3220. The current status is active.
| Licensee Name | SAMUEL CLARKE |
| Credential ID | 1510734 |
| Credential Number | 1.061754 |
| Credential Type | Physician/Surgeon |
| Business Address |
20 York St Tompkins 226 New Haven CT 06510-3220 |
| Business Type | INDIVIDUAL |
| Status | ACTIVE - CURRENT |
| Active | 1 |
| Issue Date | 2018-08-10 |
| Effective Date | 2020-08-01 |
| Expiration Date | 2021-07-31 |
| Refresh Date | 2020-05-04 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 1289430 | CSP.0060469 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 2015-06-10 | 2019-03-01 - 2021-02-28 | ACTIVE |
| 1491597 | 1.059332-RES | Resident Physician | 2017-07-01 | 2017-07-01 - 2018-06-30 | INACTIVE |
| Street Address | 20 YORK ST TOMPKINS 226 |
| City | NEW HAVEN |
| State | CT |
| Zip Code | 06510-3220 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Kirsten Cooper | 20 York St Tompkins 226, New Haven, CT 06510-3220 | Physician/surgeon | 2020-07-01 ~ 2021-06-30 |
| Makoto Mori | 20 York St Tompkins 226, New Haven, CT 06510-3220 | Resident Physician | 2020-07-01 ~ 2021-06-30 |
| Danielle Heller | 20 York St Tompkins 226, New Haven, CT 06510-3220 | Resident Physician | 2020-07-01 ~ 2021-06-30 |
| Ramya Manasvini Kaushik | 20 York St Tompkins 226, New Haven, CT 06510-3220 | Resident Physician | 2020-06-11 ~ 2021-06-30 |
| Jonathan Simon Pourmorady | 20 York St Tompkins 226, New Haven, CT 06510-3220 | Resident Physician | 2016-06-30 ~ 2021-06-30 |
| Corey Scherer | 20 York St Tompkins 226, New Haven, CT 06510-3220 | Resident Physician | 2016-06-30 ~ 2021-06-30 |
| Alan Koff | 20 York St Tompkins 226, New Haven, CT 06510-3220 | Resident Physician | 2018-07-01 ~ 2021-06-30 |
| Bethel Girma Shiferaw | 20 York St Tompkins 226, New Haven, CT 06510-3220 | Resident Physician | 2016-07-01 ~ 2021-06-30 |
| Cesia Maria Gallegos Kattan | 20 York St Tompkins 226, New Haven, CT 06510-3220 | Resident Physician | 2016-06-27 ~ 2021-06-30 |
| Fauzia Riaz | 20 York St Tompkins 226, New Haven, CT 06510-3220 | Resident Physician | 2016-06-27 ~ 2021-06-30 |
| Find all Licenses in the same address | |||
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Charu Singh | 20 York St., New Haven, CT 06510-3220 | Resident Physician | 2020-07-01 ~ 2021-06-30 |
| Abhijeet Gummadavelli | 20 York St Lci 8, New Haven, CT 06510-3220 | Resident Physician | 2020-07-01 ~ 2021-06-30 |
| Kelly Mcginnis Hager | 20 York St Rm 226, New Haven, CT 06510-3220 | Resident Physician | 2020-07-01 ~ 2021-06-30 |
| Raymond A Jean | 20 York St Tompkins 209, New Haven, CT 06510-3220 | Resident Physician | 2020-07-01 ~ 2021-06-30 |
| Jenny Yang | 20 York St Tompkins 2 Rm 226, New Haven, CT 06510-3220 | 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 |
| Adrienne Brooke Mejia | 20 York Street, Tompkins 2, Room 226, New Haven, CT 06510-3220 | Resident Physician | 2020-07-01 ~ 2021-06-30 |
| Lamia Y Haque | 20 York St Tmp 209, New Haven, CT 06510-3220 | Resident Physician | 2016-08-22 ~ 2021-06-30 |
| Melissa A Gibson | 20 York St Lmp 1072, New Haven, CT 06510-3220 | Resident Physician | 2016-06-30 ~ 2021-06-30 |
| Dennis L Shung | 20 York St Tomkins 209, New Haven, CT 06510-3220 | Resident Physician | 2017-07-01 ~ 2021-06-30 |
| Find all Licenses in zip 06510-3220 | |||
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Gary P Bernardi Jr | Yale New Haven Hospital, New Haven, CT 06510 | Advanced Practice Registered Nurse | 2020-07-01 ~ 2021-06-30 |
| Katherine G Kennedy | 65 Trumbull St, New Haven, CT 06510 | Physician/surgeon | 2020-07-01 ~ 2021-06-30 |
| Molly Elizabeth Mcadow | 333 Cedar Street, New Haven, CT 06510 | Physician/surgeon | 2020-07-01 ~ 2021-06-30 |
| Brady Dunkle | 58 Vernon Street, New Haven, CT 06510 | Registered Nurse | ~ |
| Karin Ann Price | 20 York St, New Haven, Ct 06510, New Haven, CT 06510 | Registered Nurse - Temporary | 2020-06-25 ~ 2020-10-23 |
| G C S Constuction LLC | 142 Temple Street, New Haven, CT 06510 | Major Contractor | 2020-07-01 ~ 2021-06-30 |
| Paul L Mccarthy Md · Yale School of Medicine | Dept of Pediatrics, New Haven, CT 06510 | Physician/surgeon | 2020-09-01 ~ 2021-08-31 |
| Lauren E Cohn Md | Yale New-haven Hospital, New Haven, CT 06510 | Physician/surgeon | 2020-07-01 ~ 2021-06-30 |
| Bong Francois | 900 Chapel St Apt 901, New Haven, CT 06510 | Combination Nail Technician, Esthetician Or Eyelash Technici | ~ |
| Pelli Clarke Pelli Architects Inc. | 1056 Chapel St, New Haven, CT 06510 | Architecture Corporation | 2020-08-01 ~ 2021-07-31 |
| Find all Licenses in zip 06510 | |||
| City | NEW HAVEN |
| Zip Code | 06510 |
| License Type | Physician/Surgeon |
| License Type + County | Physician/Surgeon + NEW HAVEN |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Samuel Song | 1150 North Indian Canyon Drive, Palm Springs, CA 92262 | Physician/surgeon | 2020-06-01 ~ 2021-05-31 |
| Cynthia Clarke | 31 Backland Rd, Glastonbury, CT 06073 | Physician/surgeon | 2020-04-01 ~ 2021-03-31 |
| Tracy-ann M Clarke-leconte | 1 Jeanine Ct, Dix Hills, NY 11746 | Physician/surgeon | 2019-08-01 ~ 2020-07-31 |
| John S Clarke | 1545 Cumberland Rd, Tyler, TX 75703 | Physician/surgeon | 2001-02-09 ~ 2002-02-28 |
| Astrid G Clarke | 1 Powder Horn Dr, Palm Coast, FL 32164-6703 | Physician/surgeon | 2020-05-01 ~ 2021-04-30 |
| Virginia L Gray-clarke | 10 Applewood Ln, Cornwall Bridge, CT 06754-1239 | Physician/surgeon | 2020-06-01 ~ 2021-05-31 |
| Anthony A Clarke | 36207 Town Green Drive, Elmsford, NY 10523 | Physician/surgeon | 2018-05-01 ~ 2019-04-30 |
| Delphia M Clarke | 11995 Singletree Lane, Eded Prairie, MN 55344 | Physician/surgeon | 2020-05-01 ~ 2021-04-30 |
| Akinola O Ayodeji Md | 1118 Ross Clarke Circle, Dothan, AL 36301 | Physician/surgeon | 2003-02-18 ~ 2004-03-31 |
| Mario Rodenas Md | 1505 Fort Clarke Blvd, Gainesville, FL 32606 | Physician/surgeon | 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).