CARLA DESANTIS MD (Credential# 554115) is licensed (Physician/surgeon) with Connecticut Department of Consumer Protection. The license effective date is June 1, 2020. The license expiration date date is May 31, 2021. The license status is ACTIVE.
CARLA DESANTIS MD is licensed with the Department of Consumer Protection of Connecticut. The credential number is #1.036524. The credential type is physician/surgeon. The effective date is June 1, 2020. The expiration date is May 31, 2021. The business address is 170 Hazard Ave, Enfield, CT 06082-4520. The current status is active.
| Licensee Name | CARLA DESANTIS MD |
| Credential ID | 554115 |
| Credential Number | 1.036524 |
| Credential Type | Physician/Surgeon |
| Business Address |
170 Hazard Ave Enfield CT 06082-4520 |
| Business Type | INDIVIDUAL |
| Status | ACTIVE - CURRENT |
| Active | 1 |
| Issue Date | 1997-12-05 |
| Effective Date | 2020-06-01 |
| Expiration Date | 2021-05-31 |
| Refresh Date | 2020-04-30 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 192057 | CSP.0026360 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 1999-03-01 | 2019-03-01 - 2021-02-28 | ACTIVE |
| Street Address | 170 HAZARD AVE |
| City | ENFIELD |
| State | CT |
| Zip Code | 06082-4520 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Hemant K Panchal, Md | 170 Hazard Ave, Enfield, CT 06082-4520 | Physician/surgeon | 2020-07-01 ~ 2021-06-30 |
| Thomas Baird Fitzgerald | 170 Hazard Ave, Enfield, CT 06082-4520 | Physician/surgeon | 2020-05-01 ~ 2021-04-30 |
| Timothy Machon | 170 Hazard Ave, Enfield, CT 06082-4520 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| The Jug Shop | 80 Hazard Ave, Enfield, CT 06082-4520 | Lottery Sales Agent | 2020-04-01 ~ 2021-03-31 |
| Robert P Dudek | 140 Hazard Ave Ste 101, Enfield, CT 06082-4520 | Physician/surgeon | 2020-03-01 ~ 2021-02-28 |
| Johnson Memorial Hospital Inc of Stafford Springs Ct | 142 Hazard Avenue, Enfield, CT 06082-4520 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Jeffrey C Wint | 115 Elm Street Suite 208, Enfield, CT 06082-4520 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Northeast Regional Radiation Oncology Network Inc. · Community Cancercare | 142 Hazard Ave, Enfield, CT 06082-4520 | Outpatient Clinic | 2012-10-01 ~ 2016-09-30 |
| Satish Panchal · Jug Shop (the) | 80 Hazard Ave, Enfield, CT 06082-4520 | Package Store Liquor | 2019-09-29 ~ 2020-09-28 |
| Richard T Martin | 115 Elm Street, Enfield, CT 06082-4520 | Controlled Substance Registration for Practitioner | 2015-03-01 ~ 2017-02-28 |
| Jeffrey W Wiesner Sr · Jug Shop | 80 Hazard Ave, Enfield, CT 06082-4520 | Package Store Liquor | 2011-04-14 ~ 2012-04-13 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Kaitlyn A Pelligrinelli | 38 Haynes St, Enfield, CT 06082 | Registered Nurse | 2020-07-01 ~ 2021-06-30 |
| Sharon M Smith | 11 Eleanor Rd, Enfield, CT 06082 | Registered Nurse | 2020-07-01 ~ 2021-06-30 |
| Kerry A Tanguay · Lang | 11 Somers Road, Enfield, CT 06082 | Registered Nurse | 2020-07-01 ~ 2021-06-30 |
| Colleen E Galbraith | 12 Southview St, Enfield, CT 06082 | Registered Nurse | 2020-07-01 ~ 2021-06-30 |
| Paul F Misbach | 502 Taylor Road, Enfield, CT 06082 | Real Estate Salesperson | ~ |
| Catherine R Mcculloch | 84 Wynwood Drive, Enfield, CT 06082 | Registered Nurse | 2020-08-01 ~ 2021-07-31 |
| Phillip G Seidel | 318 North Maple St, Enfield, CT 06082 | Optician | 2020-05-01 ~ 2021-04-30 |
| Matthew Crossen | 19 Elan Street, Enfield, CT 06082 | Real Estate Salesperson | 2020-06-19 ~ 2021-05-31 |
| Baco's Pizza Inc | 410 Enfield St, Enfield, CT 06082 | Bakery | 2020-07-01 ~ 2021-06-30 |
| Jessica G Martin | 72 Belmont Ave, Enfield, CT 06082 | Real Estate Salesperson | 2020-06-01 ~ 2021-05-31 |
| Find all Licenses in zip 06082 | |||
| City | ENFIELD |
| Zip Code | 06082 |
| License Type | Physician/Surgeon |
| License Type + County | Physician/Surgeon + ENFIELD |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Timothy Q Desantis | 85 Viscount Dr, Milford, CT 06460 | Physician/surgeon | 1997-04-02 ~ 1998-05-31 |
| Mark Desantis | 353 Martin Drive, West Islip, NY 11795 | Physician/surgeon | 2020-02-01 ~ 2021-01-31 |
| Carla B Marienfeld Md | 47 Squire Ln, Hamden, CT 06518-1417 | Physician/surgeon | 2016-04-01 ~ 2017-03-31 |
| Carla Casulo | 211 Washington Ave, Hamden, CT 06518 | Physician/surgeon | 2007-08-06 ~ 2008-09-30 |
| Carla S Rothaus | 22 Berkeley Rd, Westport, CT 06880 | Physician/surgeon | 1999-06-08 ~ 2000-07-31 |
| Carla R Sandberg | West Hartford, CT 06119 | Physician/surgeon | 2016-04-01 ~ 2017-03-31 |
| Carla Gergi Sawan | Apartment 5g, New York, NY 10128 | Physician/surgeon | ~ |
| Carla E Mcleod Md | 49 Crescent Street, Middletown, CT 06457 | Physician/surgeon | 2020-05-01 ~ 2021-04-30 |
| Carla R Gunn | 388 West Center St, Manchester, CT 06040 | Physician/surgeon | 2020-08-01 ~ 2021-07-31 |
| Carla L Maffeo-mitchell | 100 Retreat Ave Ste 900, Hartford, CT 06106-2528 | Physician/surgeon | 2020-08-01 ~ 2021-07-31 |
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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).