ELLIS I EFOBI MD (Credential# 563682) is licensed (Physician/surgeon) with Connecticut Department of Consumer Protection. The license effective date is January 25, 2008. The license expiration date date is March 31, 2009. The license status is INACTIVE.
ELLIS I EFOBI MD is licensed with the Department of Consumer Protection of Connecticut. The credential number is #1.046100. The credential type is physician/surgeon. The effective date is January 25, 2008. The expiration date is March 31, 2009. The business address is 2039 Cooper Lakes Dr, Grayson, GA 30017-1930. The current status is inactive.
| Licensee Name | ELLIS I EFOBI MD |
| Credential ID | 563682 |
| Credential Number | 1.046100 |
| Credential Type | Physician/Surgeon |
| Business Address |
2039 Cooper Lakes Dr Grayson GA 30017-1930 |
| Business Type | INDIVIDUAL |
| Status | INACTIVE - LAPSED DUE TO NON-RENEWAL |
| Issue Date | 2007-12-24 |
| Effective Date | 2008-01-25 |
| Expiration Date | 2009-03-31 |
| Refresh Date | 2009-07-11 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 492495 | CSP.0043025 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 2008-02-27 | 2008-02-27 - 2009-02-28 | INACTIVE |
| Street Address | 2039 COOPER LAKES DR |
| City | GRAYSON |
| State | GA |
| Zip Code | 30017-1930 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Leithia Hyacinth Martin | 2470 Tyler Bay Lane, Grayson, GA 30017 | Registered Nurse | ~ |
| Mona Marie Lewis | 2300 Arlington Walk Lane, Grayson, GA 30017 | Registered Nurse | 2018-12-03 ~ 2019-12-31 |
| Brandy Chimere Calhoun | 570 Rosewood Trail, Grayson, GA 30017 | Registered Nurse | 2020-09-01 ~ 2021-08-31 |
| Giselle Volney | 878 Winding Down Way, Grayson, GA 30017 | Resident Physician | 2019-06-24 ~ 2022-06-30 |
| Ashley Danielle Deberry | 1621 Annapolis Way, Grayson, GA 30017 | Registered Nurse | 2020-02-01 ~ 2021-01-31 |
| Mona Zakaria Salman-idris | 1423 Amber Hill Lane, Grayson, GA 30017 | Registered Nurse | 2020-03-01 ~ 2021-02-28 |
| Loraine M Clue | 2576 Madison Mae Lane, Grayson, GA 30017 | Registered Nurse | 2019-08-01 ~ 2020-07-31 |
| Erica Alexandria Atkinson | 2671 Farmstead Court, Grayson, GA 30017 | Registered Nurse | 2019-02-04 ~ 2020-01-31 |
| Florence Armour | 2149 Reddy Farm Lane, Grayson, GA 30017 | Registered Nurse - Temporary | 2017-12-18 ~ 2018-04-16 |
| Brian J May | 1180 Mount Mckinley Drive, Grayson, GA 30017 | Professional Engineer | 2001-02-01 ~ 2002-01-31 |
| Find all Licenses in zip 30017 | |||
| City | GRAYSON |
| Zip Code | 30017 |
| License Type | Physician/Surgeon |
| License Type + County | Physician/Surgeon + GRAYSON |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Scott Ellis | 523 E 72nd St Fl 5, New York, NY 10021-4099 | Physician/surgeon | ~ |
| Richard A Fraser | 5 Ellis Ct, Rye, NY 10580 | Physician/surgeon | 2010-12-01 ~ 2011-11-30 |
| Ellen P Ellis | 30 Park Ave, New York, NY 10016 | Physician/surgeon | 1991-12-20 ~ 1992-12-31 |
| James H Ellis | 103 N Redbud Ct, Mahomet, IL 61853-9284 | Physician/surgeon | 2020-04-01 ~ 2021-03-31 |
| Peter J Ellis Md | 34 Autumn St, New Haven, CT 06511-2221 | Physician/surgeon | 2020-07-01 ~ 2021-06-30 |
| Ellis A Perlswig | 30 Bryden Terr, Hamden, CT 06517 | Physician/surgeon | 2007-04-19 ~ 2008-03-31 |
| Issam A Awad | 5801 S Ellis Ave, Chicago, IL 60637-5418 | Physician/surgeon | 2011-10-01 ~ 2012-09-30 |
| Michael Joseph Ellis | 47 Barberie Ave, Highlands, NJ 07732-1517 | Physician/surgeon | 2020-06-01 ~ 2021-05-31 |
| Felix L Ellis | 4 Stuyvesant Oval, New York, NY 10009 | Physician/surgeon | 2002-01-31 ~ 2002-09-12 |
| Richard Ellis Md | 134 Birch Hill Rd, Weston, CT 06883 | Physician/surgeon | 2020-07-01 ~ 2021-06-30 |
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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).