MARY G KELLOGG MD (Credential# 553040) is licensed (Physician/surgeon) with Connecticut Department of Consumer Protection. The license effective date is July 1, 2016. The license expiration date date is June 30, 2017. The license status is INACTIVE.
MARY G KELLOGG MD is licensed with the Department of Consumer Protection of Connecticut. The credential number is #1.035447. The credential type is physician/surgeon. The effective date is July 1, 2016. The expiration date is June 30, 2017. The business address is 540 Barn Hill Rd, Monroe, CT 06468-1419. The current status is inactive.
| Licensee Name | MARY G KELLOGG MD |
| Doing Business As | MHS PRIMARY CARE INCORPORATED |
| Credential ID | 553040 |
| Credential Number | 1.035447 |
| Credential Type | Physician/Surgeon |
| Business Address |
540 Barn Hill Rd Monroe CT 06468-1419 |
| Business Type | INDIVIDUAL |
| Status | INACTIVE - LAPSED DUE TO NON-RENEWAL |
| Issue Date | 1996-08-02 |
| Effective Date | 2016-07-01 |
| Expiration Date | 2017-06-30 |
| Refresh Date | 2017-10-03 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 943698 | CSP.0047992 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 2010-07-19 | 2015-03-01 - 2017-02-28 | INACTIVE |
| 177860 | CSP.0024736 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 2008-03-01 - 2009-02-28 | INACTIVE |
| Street Address | 540 BARN HILL RD |
| City | MONROE |
| State | CT |
| Zip Code | 06468-1419 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Kenneth M Kellogg | 540 Barn Hill Rd, Monroe, CT 06468-1419 | Paramedic | 2020-01-01 ~ 2020-12-31 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Liliya Maklyan | 31 Pastors Walk, Monroe, CT 06468 | Esthetician | ~ |
| Marion K Becker | 54 Greenwood Drive, Monroe, CT 06468 | Licensed Practical Nurse | 2020-09-01 ~ 2021-08-31 |
| Valerie Matte-zabin | 139 Bart Rd, Monroe, CT 06468 | Hairdresser/cosmetician | 2020-09-01 ~ 2022-08-31 |
| Hang T Dang | 150 Main St, Monroe, CT 06468 | Combination Nail Technician, Esthetician Or Eyelash Technici | 2020-06-26 ~ 2022-06-30 |
| Leanne M Grace | 79 Pastors Walk, Monroe, CT 06468 | Hairdresser/cosmetician | 2020-09-01 ~ 2022-08-31 |
| Alicia Marie Walker | 12 Edgewood Road, Monroe, CT 06468 | Registered Nurse | 2020-08-01 ~ 2021-07-31 |
| Trina Duong | 202f Windgate Cir, Monroe, CT 06468 | Nail Technician | ~ |
| Julie M Boardman | 95 Richards Drive, Monroe, CT 06468 | Registered Nurse | 2020-06-01 ~ 2021-05-31 |
| Marilia Curral Giacobbe | 260 Cutlers Farm Road, Monroe, CT 06468 | Notary Public Appointment | 2015-03-01 ~ 2020-02-28 |
| Jane E Allen · Eschweiler | 3 Timber Dr, Monroe, CT 06468 | Registered Nurse | 2020-08-01 ~ 2021-07-31 |
| Find all Licenses in zip 06468 | |||
| City | MONROE |
| Zip Code | 06468 |
| License Type | Physician/Surgeon |
| License Type + County | Physician/Surgeon + MONROE |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Philip T Ho Md | 685 Kellogg Ave, Palo Alto, CA 94301 | Physician/surgeon | 2020-03-01 ~ 2021-02-28 |
| Taimur Habib | 19 Kellogg Street, Ridgefield, CT 06877 | Physician/surgeon | 2020-03-01 ~ 2021-02-28 |
| Robert B Cooper | 102 Kellogg Street, Brookfield, CT 06804 | Physician/surgeon | 2019-12-01 ~ 2020-11-30 |
| Sanford M Kellogg · Kellogg Bros Inc | 167 Olmstead Hill Rd, Wilton, CT 06897 | Home Improvement Contractor | 1995-12-21 ~ 1996-11-30 |
| Michael Kellogg · Kellogg Carpentry | 18 Meadow St, Seymour, CT 06483 | Home Improvement Contractor | 2019-12-01 ~ 2020-11-30 |
| Mary C Cross | 1111 Kellogg Ave, Utica, NY 13502 | Licensed Practical Nurse | 2002-09-26 ~ 2003-10-31 |
| Mary G. Kellogg | 540 Barn Hill Road, Monroe, CT 06468 | Honey Bee Registration | 2006-01-01 ~ 2006-12-31 |
| Mary S D Ghaly | Po Box 483, Niantic, CT 06357 | Physician/surgeon | 2019-02-01 ~ 2020-01-31 |
| Mary C. Banda | 72 Lawrence Dr, Longmeadow, MA 01106-1618 | Physician/surgeon | ~ |
| Mary H Windels | 85 Seymour St Ste 409, Hartford, CT 06106-5523 | Physician/surgeon | 2019-08-01 ~ 2020-07-31 |
Please comment or provide details below to improve the information on MARY G KELLOGG MD.
| 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).