LISA G FILLMORE MD (Credential# 555573) 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.
LISA G FILLMORE MD is licensed with the Department of Consumer Protection of Connecticut. The credential number is #1.037983. The credential type is physician/surgeon. The effective date is June 1, 2020. The expiration date is May 31, 2021. The business address is 196 Canner St, New Haven, CT 06511-2233. The current status is active.
| Licensee Name | LISA G FILLMORE MD |
| Credential ID | 555573 |
| Credential Number | 1.037983 |
| Credential Type | Physician/Surgeon |
| Business Address |
196 Canner St New Haven CT 06511-2233 |
| Business Type | INDIVIDUAL |
| Status | ACTIVE - CURRENT |
| Active | 1 |
| Issue Date | 1999-07-23 |
| Effective Date | 2020-06-01 |
| Expiration Date | 2021-05-31 |
| Refresh Date | 2020-06-16 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 322706 | CSP.0032824 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 2002-10-07 | 2019-04-24 - 2021-02-28 | ACTIVE |
| Street Address | 196 CANNER ST |
| City | NEW HAVEN |
| State | CT |
| Zip Code | 06511-2233 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Montessori School On Edgewood Inc. | 230 Edgewood Avenue, New Haven, CT 06511 | Public Charity | 2019-06-01 ~ 2020-05-31 |
| Therese Parks · Visel Drug Store | 264 Munson St, New Haven, CT 06511 | Registered Nurse | 2020-07-01 ~ 2021-06-30 |
| Dazjia Monet Green | 115 Edgewood Ave Apt 64, New Haven, CT 06511 | Registered Nurse | 2020-06-27 ~ 2021-05-31 |
| Carol Yam | 343 Humphrey St, New Haven, CT 06511 | Registered Nurse | ~ |
| Marwan S Haddad | 38 Lincoln Street, New Haven, CT 06511 | Physician/surgeon | 2020-07-01 ~ 2021-06-30 |
| Mary Lou Gaeta Md | 558 Chapel Street, New Haven, CT 06511 | Physician/surgeon | 2020-07-01 ~ 2021-06-30 |
| Cary M Tucker | 64 Bishop St, New Haven, CT 06511 | Architect | 2020-08-01 ~ 2021-07-31 |
| Frank J Pannenborg | 505 Ellsworth Ave, New Haven, CT 06511 | Architect | 2020-08-01 ~ 2021-07-31 |
| Crystal E Gooding | 26 Woodland Street, New Haven, CT 06511 | Notary Public Appointment | 2020-07-01 ~ 2025-06-30 |
| Kieran Jones | 260 Crown St Unit 1f, New Haven, CT 06511 | Registered Nurse | ~ |
| Find all Licenses in zip 06511 | |||
| City | NEW HAVEN |
| Zip Code | 06511 |
| License Type | Physician/Surgeon |
| License Type + County | Physician/Surgeon + NEW HAVEN |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Jonathan J Fillmore Md | 1625 Straits Tpke, Middlebury, CT 06762-1836 | Physician/surgeon | 2020-03-01 ~ 2021-02-28 |
| Ana Lisa Carr | Po Box 34457, Omaha, NE 68134-0457 | Physician/surgeon | ~ |
| Nicole M Absar | 58 Lisa Ave, Plymouth, MA 02360-5016 | Physician/surgeon | ~ |
| Lisa J Trencher | 2-11 B Peck Ave, Rye, NY 10580 | Physician/surgeon | 1999-05-20 ~ 2000-05-31 |
| Lisa Das | 26 Tamie Way, Pittsfield, MA 01201 | Physician/surgeon | 2000-01-24 ~ 2001-03-31 |
| Canyon Ozf Fillmore L.p. | 2000 Aveenue of The Stars, Fl 11, Los Angeles, CA 90067 | Securities - Exemptions | 2020-03-11 ~ |
| Lisa M. Fitzgerald | 16 Chauncy St, Cambridge, MA 02138-2439 | Physician/surgeon | 1987-05-01 ~ 1992-05-31 |
| Lisa S Visscher Md | 9 Washington Ave, Hamden, CT 06518 | Physician/surgeon | 2020-03-01 ~ 2021-02-28 |
| Lisa M Donofrio | 71 Wall St, Madison, CT 06443 | Physician/surgeon | 2020-03-01 ~ 2021-02-28 |
| Lisa A Burch | 119 Hart St, New Britain, CT 06052 | Physician/surgeon | 1994-02-14 ~ 1995-03-31 |
Please comment or provide details below to improve the information on LISA G FILLMORE 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).