PHILIP A MONGELLUZZO JR. (Credential# 556475) 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.
PHILIP A MONGELLUZZO JR. is licensed with the Department of Consumer Protection of Connecticut. The credential number is #1.038887. The credential type is physician/surgeon. The effective date is June 1, 2020. The expiration date is May 31, 2021. The business address is 2247 East Main St., Waterbury, CT 06705. The current status is active.
| Licensee Name | PHILIP A MONGELLUZZO JR. |
| Credential ID | 556475 |
| Credential Number | 1.038887 |
| Credential Type | Physician/Surgeon |
| Business Address |
2247 East Main St. Waterbury CT 06705 |
| Business Type | INDIVIDUAL |
| Status | ACTIVE - PRIOR DISCIPLINE |
| Active | 1 |
| Issue Date | 2000-07-25 |
| Effective Date | 2020-06-01 |
| Expiration Date | 2021-05-31 |
| Refresh Date | 2020-03-01 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 238702 | CSP.0029673 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 2000-08-02 | 2019-03-01 - 2021-02-28 | ACTIVE |
| 863850 | 70.921747 | Emergency Medical Technician | 1992-08-01 | - 1994-09-30 | INACTIVE |
| Street Address | 2247 East Main St. |
| City | Waterbury |
| State | CT |
| Zip Code | 06705 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Nancy L Gonzalez | 141 Decicco Road, Waterbury, CT 06705 | Licensed Practical Nurse | 2020-08-01 ~ 2021-07-31 |
| Cara Anne Mahony | 80 Craigie Ave, Waterbury, CT 06705 | Registered Nurse | 2020-07-01 ~ 2021-06-30 |
| Jocelyn Dennise Garcia | 38 Stonewall Lane, Waterbury, CT 06705 | Licensed Practical Nurse | 2020-07-01 ~ 2021-06-30 |
| Rosa Tenezaca | 24 Wall St Apt 1st, Waterbury, CT 06705 | Combination Nail Technician, Esthetician Or Eyelash Technici | ~ |
| Spinella Bakery | 53 Interstate Lane, Waterbury, CT 06705 | Bakery | 2020-07-01 ~ 2021-06-30 |
| Penelope Ortiz | 42 Gayridge Rd Apt 3-1, Waterbury, CT 06705 | Licensed Practical Nurse | 2020-06-01 ~ 2021-05-31 |
| Sandra Arias | 57 Howard St., Waterbury, CT 06705 | Combination Nail Technician, Esthetician Or Eyelash Technici | ~ |
| Waldemar Lopes | 10 Mansfield Ave, Waterbury, CT 06705 | Medication Administration Certification | 2020-05-16 ~ 2022-05-15 |
| Briana Yvette Hurdle | 235 Academy Avenue, Waterbury, CT 06705 | Esthetician | ~ |
| Jason Bradway | 93 Midland Road, Waterbury, CT 06705 | Notary Public Appointment | 2020-09-01 ~ 2025-08-31 |
| Find all Licenses in zip 06705 | |||
| City | Waterbury |
| Zip Code | 06705 |
| License Type | Physician/Surgeon |
| License Type + County | Physician/Surgeon + Waterbury |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Philip A Mongelluzzo | P.o. Box 6237, Wolcott, CT 06716 | Real Estate Salesperson | 2013-06-01 ~ 2014-05-31 |
| Gino J Mongelluzzo | 213 W 3rd St, Bloomsburg, PA 17815 | Resident Physician | 2015-06-25 ~ 2019-06-30 |
| Philip H Glogover | Aventura, FL 33180 | Physician/surgeon | 2020-02-01 ~ 2021-01-31 |
| Philip B Jensen | Po Box 606, Lincoln, MA 01773-0606 | Physician/surgeon | 2020-05-01 ~ 2021-04-30 |
| Philip R Orlander | Univ Tx Med Sch Hst, Houston, TX 77025 | Physician/surgeon | 2019-11-01 ~ 2020-10-31 |
| Philip A Waldor | 37 Ivy Road, Wilmington, DE 19806 | Physician/surgeon | 2003-04-07 ~ 2004-05-31 |
| Philip E Sumner | 6 Tunxis Dr, Farmington, CT 06032-2814 | Physician/surgeon | 1998-04-13 ~ 1999-05-31 |
| Philip S Brezina | 28 Broadview St, Bristol, CT 06010 | Physician/surgeon | 1993-10-25 ~ 1994-10-31 |
| Philip D Henry | 163 Main St, Seymour, CT 06483 | Physician/surgeon | 1998-01-06 ~ 1999-01-31 |
| Philip D Williams Md | 300 George St Ste 901, New Haven, CT 06511-6662 | Physician/surgeon | 2012-06-01 ~ 2013-05-31 |
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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).