MADELEINE KHUMBULANI LEE CARROLL (Credential# 2052164) is licensed (Resident Physician) with Connecticut Department of Consumer Protection. The license effective date is June 9, 2020. The license expiration date date is June 30, 2021. The license status is ACTIVE.
MADELEINE KHUMBULANI LEE CARROLL is licensed with the Department of Consumer Protection of Connecticut. The credential number is #1.065921-RES. The credential type is resident physician. The effective date is June 9, 2020. The expiration date is June 30, 2021. The business address is 20 York St Rm 226, New Haven, CT 06510-3220. The current status is active.
| Licensee Name | MADELEINE KHUMBULANI LEE CARROLL |
| Credential ID | 2052164 |
| Credential Number | 1.065921-RES |
| Credential Type | Resident Physician |
| Credential SubCategory | RES |
| Business Address |
20 York St Rm 226 New Haven CT 06510-3220 |
| Business Type | INDIVIDUAL |
| Status | ACTIVE - CURRENT |
| Active | 1 |
| Issue Date | 2020-06-09 |
| Effective Date | 2020-06-09 |
| Expiration Date | 2021-06-30 |
| Refresh Date | 2020-06-04 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 2051698 | CSP.0074333 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 2020-06-18 | 2020-06-18 - 2021-02-28 | ACTIVE |
| Street Address | 20 YORK ST RM 226 |
| City | NEW HAVEN |
| State | CT |
| Zip Code | 06510-3220 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Kelly Mcginnis Hager | 20 York St Rm 226, New Haven, CT 06510-3220 | Resident Physician | 2020-07-01 ~ 2021-06-30 |
| Devika Dhandapani Sparks | 20 York St Rm 226, New Haven, CT 06510-3220 | Resident Physician | 2020-06-01 ~ 2021-06-30 |
| Deborah Motolani Oyeyemi | 20 York St Rm 226, New Haven, CT 06510-3220 | Resident Physician | 2020-06-11 ~ 2021-06-30 |
| Jonathan Casazola | 20 York St Rm 226, New Haven, CT 06510-3220 | Resident Physician | 2020-06-11 ~ 2021-06-30 |
| Arash Aghajani Nargesi | 20 York St Rm 226, New Haven, CT 06510-3220 | Resident Physician | 2020-07-01 ~ 2021-06-30 |
| Catherine Mezzacappa | 20 York St Rm 226, New Haven, CT 06510-3220 | Resident Physician | 2020-07-01 ~ 2021-06-30 |
| Gbambele Kone | 20 York St Rm 226, New Haven, CT 06510-3220 | Resident Physician | 2020-07-01 ~ 2021-06-30 |
| Jane Xiaojie Liao | 20 York St Rm 226, New Haven, CT 06510-3220 | Resident Physician | 2020-07-01 ~ 2021-06-30 |
| Goran Micevic | 20 York St Rm 226, New Haven, CT 06510-3220 | Resident Physician | 2020-07-01 ~ 2021-06-30 |
| Yaser Al-jobory | 20 York St Rm 226, New Haven, CT 06510-3220 | Resident Physician | 2020-07-01 ~ 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 |
| 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 |
| Allison Berken | 20 York St Tomkins 226, New Haven, CT 06510-3220 | Resident Physician | 2019-08-01 ~ 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 | Resident Physician |
| License Type + County | Resident Physician + NEW HAVEN |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Madeleine Coleman | 20 York Street, New Haven, CT 06510 | Resident Physician | 2020-07-01 ~ 2021-06-30 |
| Elizabeth Madeleine Gromet | 353 Riverside Ave, Riverside, CT 06878-2123 | Resident Physician | 2020-07-01 ~ 2021-06-30 |
| Brett Carroll | One Hospital Plaza, Stamford, CT 06904 | Resident Physician | 2016-07-01 ~ 2019-06-30 |
| Madeleine T Carroll | 25 Overbrook Rd., Norwalk, CT 06851 | Speech and Language Pathologist | 2019-11-01 ~ 2020-10-31 |
| Michael Carroll · Carroll's | 20 Fernbel Ln, W Hartford, CT 06107 | Home Improvement Contractor | 1998-07-02 ~ 1998-11-30 |
| Madeleine Kitaj Md | 1450 Maiden Lane, Yorktown Heights, NY 10598 | Physician/surgeon | 2020-03-01 ~ 2021-02-28 |
| James P Carroll · Jp Carroll Construction Inc | 1110 Farmington Avenue, West Hartford, CT 06107 | Home Improvement Contractor | 1995-08-10 ~ 1996-11-30 |
| A O Carroll & Agostini Co · Adorna O Carroll | 742 Worthington Ridge, Berlin, CT 06037 | Real Estate Broker | 1999-06-01 ~ 2000-05-31 |
| William R Carroll Jr · Carroll's Hm Imprvmnts Inc C/r | 23 Stowe Drive, Shelton, CT 06484 | Home Improvement Contractor | 1995-08-01 ~ 1996-11-30 |
| Jp Carroll Construction Inc · Jp Carroll Construction | 310r Newington Rd, West Hartford, CT 06110-2330 | Major Contractor | 2018-05-30 ~ 2019-06-30 |
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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).