JENNIFER L WONG (Credential# 1284419) 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.
JENNIFER L WONG is licensed with the Department of Consumer Protection of Connecticut. The credential number is #1.054528. The credential type is physician/surgeon. The effective date is June 1, 2020. The expiration date is May 31, 2021. The business address is 800 Howard Avenue, New Haven, CT 06519. The current status is active.
| Licensee Name | JENNIFER L WONG |
| Credential ID | 1284419 |
| Credential Number | 1.054528 |
| Credential Type | Physician/Surgeon |
| Business Address |
800 Howard Avenue New Haven CT 06519 |
| Business Type | INDIVIDUAL |
| Status | ACTIVE - CURRENT |
| Active | 1 |
| Issue Date | 2015-08-12 |
| Effective Date | 2020-06-01 |
| Expiration Date | 2021-05-31 |
| Refresh Date | 2020-06-02 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 1300659 | CSP.0061030 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 2015-09-01 | 2019-03-01 - 2021-02-28 | ACTIVE |
| 411688 | CSP.0037867 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 2005-08-04 | 2008-07-22 - 2009-02-28 | INACTIVE |
| 1301224 | 1 | Physician/Surgeon | - | PENDING |
| Street Address | 800 Howard Avenue |
| City | New Haven |
| State | CT |
| Zip Code | 06519 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Michael J Medvecky Md | 800 Howard Avenue, New Haven, CT 06520 | Physician/surgeon | 2020-08-01 ~ 2021-07-31 |
| Ayse Sule Tinaz | 800 Howard Avenue, New Haven, CT 06519 | Physician/surgeon | 2020-07-01 ~ 2021-06-30 |
| Peter Jokl | 800 Howard Avenue, New Haven, CT 06520 | Physician/surgeon | 2020-07-01 ~ 2021-06-30 |
| Jorge O Moreno | 800 Howard Avenue, New Haven, CT 06519 | Physician/surgeon | 2020-05-01 ~ 2021-04-30 |
| Saral Mehra | 800 Howard Avenue, New Haven, CT 06520 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Daniel B Dicapua | 800 Howard Avenue, New Haven, CT 06519 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Dieter M Lindskog Md | 800 Howard Avenue, New Haven, CT 06520 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Haven Free Clinic | 800 Howard Avenue, New Haven, CT 06510 | Outpatient Clinic | 2017-02-14 ~ 2020-12-31 |
| James C Alex | 800 Howard Avenue, New Haven, CT 06520-1304 | Physician/surgeon | 2003-01-22 ~ 2004-03-31 |
| Kenneth B Briskin Md | 800 Howard Avenue, New Haven, CT 06520 | Controlled Substance Registration for Practitioner | 1997-03-01 ~ 1998-02-28 |
| Find all Licenses in the same address | |||
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Vinod H Srihari Md | 34 Park St Cmhc, New Haven, CT 06519 | Physician/surgeon | 2020-09-01 ~ 2021-08-31 |
| Monica Brito Salinas | 111 Kimberly Ave., New Haven, CT 06519 | Combination Nail Technician, Esthetician Or Eyelash Technici | 2020-06-27 ~ 2022-02-28 |
| Walter Mathis | 34 Park St., New Haven, CT 06519 | Physician/surgeon | 2020-07-01 ~ 2021-06-30 |
| Kimberly Pizza · Emmanuel Zorgias | 34 Kimberly Ave, New Haven, CT 06519 | Bakery | 2020-07-01 ~ 2021-06-30 |
| Slawomir Piascik | 51 Longhini Lane, New Haven, CT 06519 | Asbestos Abatement Supervisor | 2020-08-01 ~ 2021-07-31 |
| Margaret T Boron | 428 Columbus Ave, New Haven, CT 06519 | Physician/surgeon | 2020-07-01 ~ 2021-06-30 |
| Laura Ann Dicola | Connecticut Mental Health Center Law & Psychiatry, New Haven, CT 06519 | Physician/surgeon | 2020-07-01 ~ 2021-06-30 |
| Elizabeth Parson | 689 Congress Ave, New Haven, CT 06519 | Medication Administration Certification | 2020-08-05 ~ 2022-08-04 |
| Alejandra Lopez Cervantes | 10 Hedge St, New Haven, CT 06519 | Combination Nail Technician, Esthetician Or Eyelash Technici | 2020-06-20 ~ 2021-08-31 |
| Deicy Alexandra Urena Dagua | 267 Howard Ave, New Haven, CT 06519 | Combination Nail Technician, Esthetician Or Eyelash Technici | 2020-06-20 ~ 2021-10-31 |
| Find all Licenses in zip 06519 | |||
| City | New Haven |
| Zip Code | 06519 |
| License Type | Physician/Surgeon |
| License Type + County | Physician/Surgeon + New Haven |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Brian Wong | 462 Queen St., Southington, CT 06489 | Physician/surgeon | 2020-05-01 ~ 2021-04-30 |
| Anselm Wong Md | 38 Republic Dr Apt 129, Bloomfield, CT 06002-5465 | Physician/surgeon | 2012-09-01 ~ 2013-08-31 |
| Kei Wong | 100 York Street, New Haven, CT 06511 | Physician/surgeon | 2020-04-01 ~ 2021-03-31 |
| Edison H Wong | 801 N Orange Ave, Orlando, FL 32801 | Physician/surgeon | 2020-02-01 ~ 2021-01-31 |
| Jean Wong Md | 455 Lewis Ave Ste 210, Meriden, CT 06451-2121 | Physician/surgeon | 2020-05-01 ~ 2021-04-30 |
| Julielynn Y Wong | 828 Dundas St West, Toronto, ON M6J 1V3 | Physician/surgeon | ~ |
| James J Y Wong | 102 East Ave, Norwalk, CT 06851 | Physician/surgeon | 2020-02-01 ~ 2021-01-31 |
| Andrew S Wong | 260 Blue Trail, Hamden, CT 06518 | Physician/surgeon | 2005-09-06 ~ 2006-10-31 |
| Jeffrey E Wong | 64 Avonwood Road Apt C-7, Avon, CT 06001 | Physician/surgeon | 2000-06-28 ~ 2001-06-30 |
| Ma Li Wong | 1580 Nw 10th Avenue, Miami, FL 33136 | Physician/surgeon | 1993-02-25 ~ 1994-02-28 |
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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).