ELLEN G POLOKOFF (Credential# 553246) is licensed (Physician/surgeon) with Connecticut Department of Consumer Protection. The license effective date is April 1, 2020. The license expiration date date is March 31, 2021. The license status is ACTIVE.
ELLEN G POLOKOFF is licensed with the Department of Consumer Protection of Connecticut. The credential number is #1.035653. The credential type is physician/surgeon. The effective date is April 1, 2020. The expiration date is March 31, 2021. The business address is 900 Main St S Bldg 2 Ste 101, Southbury, CT 06488-4213. The current status is active.
| Licensee Name | ELLEN G POLOKOFF |
| Credential ID | 553246 |
| Credential Number | 1.035653 |
| Credential Type | Physician/Surgeon |
| Business Address |
900 Main St S Bldg 2 Ste 101 Southbury CT 06488-4213 |
| Business Type | INDIVIDUAL |
| Status | ACTIVE - CURRENT |
| Active | 1 |
| Issue Date | 1996-10-25 |
| Effective Date | 2020-04-01 |
| Expiration Date | 2021-03-31 |
| Refresh Date | 2020-01-08 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 53159 | CSP.0024930 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 1999-03-01 | 2019-03-01 - 2021-02-28 | ACTIVE |
| Street Address | 900 MAIN ST S BLDG 2 STE 101 |
| City | SOUTHBURY |
| State | CT |
| Zip Code | 06488-4213 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Jillian Jung | 582 Patriot Rd, Southbury, CT 06488 | Radiographer | 2020-08-01 ~ 2021-07-31 |
| Mary E Kohler | 201 Old Highway, Southbury, CT 06488 | Registered Nurse | 2020-09-01 ~ 2021-08-31 |
| Theresa K Bobak | 266b Heritage Village, Southbury, CT 06488 | Registered Nurse | 2020-08-01 ~ 2021-07-31 |
| Kelly Watson | 800 Main Street South Suite 102, Southbury, CT 06488 | Medication Administration Certification | 2018-06-27 ~ 2020-06-26 |
| Mcdonald's Rest #2104 | 44 Division St, Derby, CT 06488 | Bakery | 2020-07-01 ~ 2021-06-30 |
| Shirley A Frager | 5 West View Rd, Southbury, CT 06488 | Registered Nurse | 2020-07-01 ~ 2021-06-30 |
| Maureen K Boyd | 77 Shane Drive, Southbury, CT 06488 | Physical Therapist | 2020-09-01 ~ 2021-08-31 |
| South Britain Oil LLC | 424 Old Field Rd, Southbury, CT 06488 | Operator of Weighing & Measuring Devices | 2020-08-01 ~ 2021-07-31 |
| Won Ju Lee | 995 Old Field Rd, Southbury, CT 06488 | Combination Nail Technician, Esthetician Or Eyelash Technici | 2020-06-26 ~ 2022-01-31 |
| Mcdonald's Rest #27001 | 652 New Haven Ave, Derby, CT 06488 | Bakery | 2020-07-01 ~ 2021-06-30 |
| Find all Licenses in zip 06488 | |||
| City | SOUTHBURY |
| Zip Code | 06488 |
| License Type | Physician/Surgeon |
| License Type + County | Physician/Surgeon + SOUTHBURY |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Ellen Marqusee | Po Box 650, Chinle, AZ 86503 | Physician/surgeon | 1993-09-23 ~ 1994-10-31 |
| Ellen Sano | 615 W 131st St Fl 3, New York, NY 10027-7922 | Physician/surgeon | ~ |
| Ellen G Gold | 44 Angus Ln, Greenwich, CT 06831-4402 | Physician/surgeon | 2015-12-01 ~ 2016-11-30 |
| Ellen Gendler | 1035 Fifth Ave, New York, NY 10028 | Physician/surgeon | 2020-03-05 ~ 2021-02-28 |
| Ellen Wolfson Md | 97 Barnes Rd, Wallingford, CT 06492 | Physician/surgeon | 2007-06-08 ~ 2008-07-31 |
| Ellen Bondar | 27 Barker Ave, White Plains, NY 10601 | Physician/surgeon | ~ |
| Ellen C Wallace | 25 Stearns Rd, Watertown, MA 02172 | Physician/surgeon | 1994-11-02 ~ 1995-12-31 |
| Ellen C Denigris | 212 Old Landing Ct, Fredericksburg, VA 22405-3705 | Physician/surgeon | 2019-09-01 ~ 2020-08-31 |
| Katherine Ellen Nori Janosz | 126 5th Ave Fl 2, New York, NY 10011-5631 | Physician/surgeon | ~ |
| Ellen N Wolfson | 15 Coachlamp Ln, Greenwich, CT 06830-4002 | 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).