GARY E MOMBELLO (Credential# 541069) is licensed (Physician/surgeon) with Connecticut Department of Consumer Protection. The license effective date is May 24, 2006. The license expiration date date is July 31, 2007. The license status is INACTIVE.
GARY E MOMBELLO is licensed with the Department of Consumer Protection of Connecticut. The credential number is #1.014353. The credential type is physician/surgeon. The effective date is May 24, 2006. The expiration date is July 31, 2007. The business address is 34 Montgomery Drive, Northford, CT 06472-1379. The current status is inactive.
| Licensee Name | GARY E MOMBELLO |
| Credential ID | 541069 |
| Credential Number | 1.014353 |
| Credential Type | Physician/Surgeon |
| Business Address |
34 Montgomery Drive Northford CT 06472-1379 |
| Business Type | INDIVIDUAL |
| Status | INACTIVE - LAPSED DUE TO NON-RENEWAL |
| Issue Date | 1970-04-22 |
| Effective Date | 2006-05-24 |
| Expiration Date | 2007-07-31 |
| Refresh Date | 2009-07-08 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 149171 | CSP.0000652 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 2005-03-01 - 2006-02-28 | INACTIVE |
| Street Address | 34 Montgomery Drive |
| City | Northford |
| State | CT |
| Zip Code | 06472-1379 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Patricia Sue Pragano | 12 Montgomery Rd, Northford, CT 06472-1379 | Family Child Care Assistant | 2020-08-01 ~ 2022-07-31 |
| Karen A Trojanowski | 20 Montgomery Rd, Northford, CT 06472-1379 | Registered Nurse | 2020-02-01 ~ 2021-01-31 |
| Brenda Iezzi | 20 Montgomery Dr., Northford, CT 06472-1379 | Hairdresser/cosmetician | 2017-01-01 ~ 2018-12-31 |
| Suzanne Bergmark | 12 Montgomery Rd, Northford, CT 06472-1379 | Family Child Care Substitute | 2018-11-01 ~ 2020-10-31 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Patrizia O Lorenti | 57 Idylwood Drive, Northford, CT 06472 | Registered Nurse | 2020-07-01 ~ 2021-06-30 |
| James Lewis Rusconi | 319 Reeds Gap Road, Northford, CT 06472 | Hoisting Equipment Operator | 2018-04-27 ~ 2020-04-27 |
| Stephanie A Muraski | 14 Maplewood Lane, Northford, CT 06472 | Registered Nurse | 2020-08-01 ~ 2021-07-31 |
| Jared D Incillo | 41 Blue Trail Dr, Northford, CT 06472 | Registered Nurse | 2020-07-01 ~ 2021-06-30 |
| Joseph Ochenkowski | 84 Parsonage Hl Rd, Northford, CT 06472 | Sub-surface Sewage Installer | 2020-09-01 ~ 2021-08-31 |
| Domenic Dedomenico | 78 Woodvale Drive, Northford, CT 06472 | Water Treatment Plant Operator - Class Iv | 2020-04-01 ~ 2023-03-31 |
| Angel Wulff | 50 Mountain View Terrace, Northford, CT 06472 | Hairdresser/cosmetician | 2020-09-01 ~ 2022-08-31 |
| Kerry A Augur · Donnaruma | 132 Mill Road, Northford, CT 06472 | Registered Nurse | 2020-08-01 ~ 2021-07-31 |
| Jessica Lynn Mckee | 83 Anderson Road, Northford, CT 06472 | Master's Level Social Worker | 2020-08-01 ~ 2021-07-31 |
| Erica M Albrecht | 67 Woodhouse Ave., Northford, CT 06472 | Registered Nurse | 2020-06-17 ~ 2021-03-31 |
| Find all Licenses in zip 06472 | |||
| City | Northford |
| Zip Code | 06472 |
| License Type | Physician/Surgeon |
| License Type + County | Physician/Surgeon + Northford |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Gary T Yacono | 96 Ct-37, New Fairfield, CT 06812 | Physician/surgeon | 2020-07-01 ~ 2021-06-30 |
| Gary Leeds | 16 Elizabeth Ln, Riverside, CT 06878-1302 | Physician/surgeon | ~ |
| Gary A Dee | 294 Morehouse Rd, Easton, CT 06612-2145 | Physician/surgeon | 2020-04-01 ~ 2021-03-31 |
| Gary L Last Md | 580 Cottage Grove Rd, Bloomfield, CT 06002 | Physician/surgeon | 2020-05-01 ~ 2021-04-30 |
| Gary W. Swain Jr. | 57 E 96th St Apt 4d, New York, NY 10128-0818 | Physician/surgeon | 2011-08-01 ~ 2012-08-31 |
| Ben Gary Harvey | 42-52 Union St, Flushing, NY 11355 | Physician/surgeon | 1981-01-01 ~ 1993-05-31 |
| Gary J Kaml Md | 257 Bartlett Dr, Madison, CT 06443-1784 | Physician/surgeon | 2020-08-01 ~ 2021-07-31 |
| Gary L Gross | 903 Zaragoza St, Davis, CA 95618-5493 | Physician/surgeon | 2020-03-01 ~ 2021-02-28 |
| Gary V Desir Md | 11 Zak Hill Dr, Woodbridge, CT 06525-1654 | Physician/surgeon | 2020-07-01 ~ 2021-06-30 |
| Gary S Gordon | 600 N. Mcclurg Ct, Chicago, IL 60611 | Physician/surgeon | 1996-10-01 ~ 1997-10-31 |
Please comment or provide details below to improve the information on GARY E MOMBELLO.
| 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).