RICHARD I ENELOW MD
Physician/surgeon


Address: Va Ct.health Care System/111a 950 Campbell Ave, West Haven, CT 06516

RICHARD I ENELOW MD (Credential# 558888) is licensed (Physician/surgeon) with Connecticut Department of Consumer Protection. The license effective date is January 2, 2007. The license expiration date date is February 29, 2008. The license status is INACTIVE.

Business Overview

RICHARD I ENELOW MD is licensed with the Department of Consumer Protection of Connecticut. The credential number is #1.041305. The credential type is physician/surgeon. The effective date is January 2, 2007. The expiration date is February 29, 2008. The business address is Va Ct.health Care System/111a 950 Campbell Ave, West Haven, CT 06516. The current status is inactive.

Basic Information

Licensee Name RICHARD I ENELOW MD
Credential ID 558888
Credential Number 1.041305
Credential Type Physician/Surgeon
Business Address Va Ct.health Care System/111a 950 Campbell Ave
West Haven
CT 06516
Business Type INDIVIDUAL
Status INACTIVE - LAPSED DUE TO NON-RENEWAL
Issue Date 2003-04-01
Effective Date 2007-01-02
Expiration Date 2008-02-29
Refresh Date 2009-07-11

Other licenses

ID Credential Code Credential Type Issue Term Status
341268 CSP.0033668 CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER 2005-03-01 2007-03-01 - 2008-02-29 INACTIVE

Office Location

Street Address VA CT.HEALTH CARE SYSTEM/111A 950 CAMPBELL AVE
City WEST HAVEN
State CT
Zip Code 06516

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Junqin Wang 15 Central Ave West Haven, West Haven, CT 06516 Nail Technician ~
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Monica M Skakacz 19 Cowpen Rd, West Haven, CT 06516 Registered Nurse 2020-05-01 ~ 2021-04-30
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Dyaija Soriano 29 Ridge Court East, West Haven, CT 06516 Esthetician 2020-06-26 ~ 2022-05-31
Katherine M Grable 13 Perry Merrill Drive, West Haven, CT 06516 Licensed Practical Nurse 2020-07-01 ~ 2021-06-30
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Competitor

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City WEST HAVEN
Zip Code 06516
License Type Physician/Surgeon
License Type + County Physician/Surgeon + WEST HAVEN

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Dataset Information

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).

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