LISA BERLIN (Credential# 548761) is licensed (Physician/surgeon) with Connecticut Department of Consumer Protection. The license effective date is July 1, 2018. The license expiration date date is June 30, 2019. The license status is INACTIVE.
LISA BERLIN is licensed with the Department of Consumer Protection of Connecticut. The credential number is #1.030874. The credential type is physician/surgeon. The effective date is July 1, 2018. The expiration date is June 30, 2019. The business address is 16 Hampshire Rd, Madison, CT 06443-3355. The current status is inactive.
| Licensee Name | LISA BERLIN |
| Credential ID | 548761 |
| Credential Number | 1.030874 |
| Credential Type | Physician/Surgeon |
| Business Address |
16 Hampshire Rd Madison CT 06443-3355 |
| Business Type | INDIVIDUAL |
| Status | INACTIVE - LAPSED DUE TO NON-RENEWAL |
| Issue Date | 1990-07-01 |
| Effective Date | 2018-07-01 |
| Expiration Date | 2019-06-30 |
| Refresh Date | 2019-10-03 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 160100 | CSP.0018405 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 1999-03-01 | 2017-03-01 - 2019-02-28 | LAPSED |
| Street Address | 16 HAMPSHIRE RD |
| City | MADISON |
| State | CT |
| Zip Code | 06443-3355 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Suzanne M Blouin | 42 Hampshire Rd, Madison, CT 06443-3355 | Real Estate Salesperson | 2020-06-01 ~ 2021-05-31 |
| Barbara A Albro | 34 Hampshire Rd, Madison, CT 06443-3355 | Registered Nurse | 2020-05-01 ~ 2021-04-30 |
| Patricia Godiksen | 2 Hampshire Rd, Madison, CT 06443-3355 | Real Estate Salesperson | 2014-06-01 ~ 2015-05-31 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Caitlyn Beverly Darosa | Lyle Dr, Madison, CT 06443 | Registered Nurse | ~ |
| Roberts Food Center · Rjf Inc Dba | 514 Old Toll Rd, Madison, CT 06443 | Operator of Weighing & Measuring Devices | 2020-08-01 ~ 2021-07-31 |
| Karen D Leonetti · Rapuano | 553 Green Hill Rd, Madison, CT 06443 | Radiographer | 2020-09-01 ~ 2021-08-31 |
| Pasquale Sabatasso | 122 River Edge Farms Road, Madison, CT 06443 | Barber | 2020-07-01 ~ 2022-06-30 |
| Madision Health Foods · Jum Ok Coker | 59 Wall St, Madison, CT 06443 | Operator of Weighing & Measuring Devices | 2020-08-01 ~ 2021-07-31 |
| Madison Community Services Inc. | P.o. Box 148, Madison, CT 06443 | Public Charity | 2020-12-01 ~ 2021-11-30 |
| Shaina Michele Levinson | 52 East Wharf Rd, Madison, CT 06443 | Master's Level Social Worker | ~ |
| Stephen G Lynch · Lynch, Stephen Gerard | 12 Milestone Lane, Madison, CT 06443 | Real Estate Salesperson | 2020-06-01 ~ 2021-05-31 |
| David F Courtney Md | 38 Old Duck Hole Road, Madison, CT 06443 | Physician/surgeon | 2020-07-01 ~ 2021-06-30 |
| Sydni E Marmor | 560 Opening Hill Road, Madison, CT 06443 | Professional Counselor | 2020-07-01 ~ 2021-06-30 |
| Find all Licenses in zip 06443 | |||
| City | MADISON |
| Zip Code | 06443 |
| License Type | Physician/Surgeon |
| License Type + County | Physician/Surgeon + MADISON |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Lisa Vanty Pa | 69 Toll Gate Road, Berlin, CT 06037 | Physician Assistant | 2020-05-01 ~ 2021-04-30 |
| Darren C Volpe Md | 36 Quincy Trl, Berlin, CT 06037-3765 | Physician/surgeon | 2020-05-01 ~ 2021-04-30 |
| Gregory A Rutkowski Md | 44 Canterbury Rd, Berlin, CT 06037-3706 | Physician/surgeon | 2020-04-01 ~ 2021-03-31 |
| Bert B Berlin Md | 85 Seymour St, Hartford, CT 06106 | Physician/surgeon | 2012-11-01 ~ 2013-10-31 |
| Richard N Goldberg | 8 Woodland Ln, Berlin, CT 06037-1130 | Physician/surgeon | 2013-05-01 ~ 2013-08-04 |
| Peter A Rinaudo | 59 Skyview Dr, Berlin, CT 06037 | Physician/surgeon | 1999-11-10 ~ 2001-01-31 |
| Mark E Ludwig | 17 Iris Way, Berlin, CT 06037-5000 | Physician/surgeon | 2019-08-01 ~ 2020-07-31 |
| Miriam U Schoepf | Im Mittelbusch 9, Berlin, 14129 | Physician/surgeon | 2002-01-25 ~ 2003-03-31 |
| Lisa Das | 26 Tamie Way, Pittsfield, MA 01201 | Physician/surgeon | 2000-01-24 ~ 2001-03-31 |
| Ana Lisa Carr | Po Box 34457, Omaha, NE 68134-0457 | Physician/surgeon | ~ |
Please comment or provide details below to improve the information on LISA BERLIN.
| 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).