TINA ROMAN (Credential# 553721) is licensed (Physician/surgeon) with Connecticut Department of Consumer Protection. The license effective date is July 1, 2020. The license expiration date date is June 30, 2021. The license status is ACTIVE.
TINA ROMAN is licensed with the Department of Consumer Protection of Connecticut. The credential number is #1.036129. The credential type is physician/surgeon. The effective date is July 1, 2020. The expiration date is June 30, 2021. The business address is 520 Saybrook Rd Ste 250, Middletown, CT 06457-4700. The current status is active.
| Licensee Name | TINA ROMAN |
| Credential ID | 553721 |
| Credential Number | 1.036129 |
| Credential Type | Physician/Surgeon |
| Business Address |
520 Saybrook Rd Ste 250 Middletown CT 06457-4700 |
| Business Type | INDIVIDUAL |
| Status | ACTIVE - CURRENT |
| Active | 1 |
| Issue Date | 1997-06-27 |
| Effective Date | 2020-07-01 |
| Expiration Date | 2021-06-30 |
| Refresh Date | 2020-06-03 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 181610 | CSP.0025480 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 1999-03-29 | 2019-03-01 - 2021-02-28 | ACTIVE |
| Street Address | 520 SAYBROOK RD STE 250 |
| City | MIDDLETOWN |
| State | CT |
| Zip Code | 06457-4700 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Brad A Jubelirer | 520 Saybrook Rd Ste 250, Middletown, CT 06457-4700 | Physician/surgeon | 2020-04-01 ~ 2021-03-31 |
| Allison H Whitaker | 520 Saybrook Rd Ste 250, Middletown, CT 06457-4700 | Physician/surgeon | 2020-03-01 ~ 2021-02-28 |
| Elizabeth J Northrop | 520 Saybrook Rd Ste 250, Middletown, CT 06457-4700 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Christopher C Lawrence | 520 Saybrook Rd Ste 250, Middletown, CT 06457-4700 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Edward G Myer Md | 520 Saybrook Rd Ste 100b, Middletown, CT 06457-4700 | Physician/surgeon | 2020-04-01 ~ 2021-03-31 |
| James M Parker Jr | 540 Saybrook Rd Ste 100, Middletown, CT 06457-4700 | Physician/surgeon | 2020-06-01 ~ 2021-05-31 |
| Root Center for Advanced Recovery | 520 Saybrook Rd Ste 105, Middletown, CT 06457-4700 | Psychiatric Outpatient Clinic | 2019-11-13 ~ 2022-09-30 |
| Christina Y. Kim | 520 Saybrook Rd Fl 1, Middletown, CT 06457-4700 | Physician/surgeon | 2018-06-01 ~ 2019-05-31 |
| Dana Ufnal Kivlin | 520 Saybrook Rd, Middletown, CT 06457-4700 | Physician/surgeon | 2020-06-01 ~ 2021-05-31 |
| Timothy C. Siegrist Md | 520 Saybrook Rd, Middletown, CT 06457-4700 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Elizabeth M Mailhot | 177 Timber Ridge Rd, Middletown, CT 06457 | Dental Hygienist | 2020-08-01 ~ 2021-07-31 |
| Rebecca S Fennessy | 22 Keefe Ln, Middletown, CT 06457 | Licensed Clinical Social Worker | 2020-07-01 ~ 2021-06-30 |
| Eloise M Gagnon | 538 Bow Lane, Middletown, CT 06457 | Hairdresser/cosmetician | 2020-08-01 ~ 2022-07-31 |
| Salvatore Dimauro | 245 Dekoven Dr, Middletown, CT 06457 | Public Weigher | 2020-07-01 ~ 2021-06-30 |
| Frank L Wright | 261 Spencer Dr, Middletown, CT 06457 | Barber | 2020-08-01 ~ 2022-07-31 |
| Gino A Cardella | 50 Sonoma Lane, Middletown, CT 06457 | Real Estate Salesperson | ~ |
| Shannon Lee Mcquillan | 5 Forest Glen Circle, Middletown, CT 06457 | Registered Nurse | 2020-06-26 ~ 2020-09-30 |
| Lori Dimauro · Carta | 244 Chamberlain Hill Road, Middletown, CT 06457 | Hairdresser/cosmetician | 2020-09-01 ~ 2022-08-31 |
| Gail A Corrow | 85 Dora Dr, Middletown, CT 06457 | Real Estate Salesperson | 2020-06-01 ~ 2021-05-31 |
| Mariter V Perez | 8 Moss Glen, Middletown, CT 06457 | Registered Nurse | 2020-08-01 ~ 2021-07-31 |
| Find all Licenses in zip 06457 | |||
| City | MIDDLETOWN |
| Zip Code | 06457 |
| License Type | Physician/Surgeon |
| License Type + County | Physician/Surgeon + MIDDLETOWN |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Roman A Klufas | 50 Galen Ct., Seekonk, MA 02771 | Physician/surgeon | ~ |
| Roman W. Matlaga | 15 Bodine Ln, Honesdale, PA 18431-4047 | Physician/surgeon | 2012-01-12 ~ 2012-08-31 |
| Roman Chrucky | 5 Old Mill Rd, Trumbull, CT 06611 | Physician/surgeon | 2019-10-01 ~ 2020-09-30 |
| Roman Alder Md | 4 Main St, New Milford, CT 06776-2802 | Physician/surgeon | 2020-06-01 ~ 2021-05-31 |
| Roman A Tuma | 150 Everit Street, New Haven, CT 06511 | Physician/surgeon | 2000-02-11 ~ 2001-01-31 |
| Sanziana A Roman Md | 333 Cedar Street, New Haven, CT 06520-8062 | Physician/surgeon | 2012-07-01 ~ 2013-06-30 |
| Antonio Regino Roman | 1975 Delaware Ave, Buffalo, NY 14216-3569 | Physician/surgeon | 1988-07-08 ~ 1989-01-31 |
| Roman Khodzinsky | 37 Sara Circle, North Haven, CT 06473 | Physician/surgeon | 2020-07-01 ~ 2021-06-30 |
| Tina Sindwani | 390 11th Ave Fl 2, New York, NY 10001-1208 | Physician/surgeon | ~ |
| Tina Yin Chang | 701 5th Ave, Seattle, WA 98104 | Physician/surgeon | 2020-05-01 ~ 2021-04-30 |
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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).