CARISSA A WEBSTER-LAKE (Credential# 1309214) is licensed (Physician/surgeon) with Connecticut Department of Consumer Protection. The license effective date is April 1, 2020. The license expiration date date is March 31, 2021. The license status is ACTIVE.
CARISSA A WEBSTER-LAKE is licensed with the Department of Consumer Protection of Connecticut. The credential number is #1.054698. The credential type is physician/surgeon. The effective date is April 1, 2020. The expiration date is March 31, 2021. The business address is 1835 Union Ave Apt 219, Memphis, TN 38104-3951. The current status is active.
| Licensee Name | CARISSA A WEBSTER-LAKE |
| Credential ID | 1309214 |
| Credential Number | 1.054698 |
| Credential Type | Physician/Surgeon |
| Business Address |
1835 Union Ave Apt 219 Memphis TN 38104-3951 |
| Business Type | INDIVIDUAL |
| Status | ACTIVE - CURRENT |
| Active | 1 |
| Issue Date | 2015-10-14 |
| Effective Date | 2020-04-01 |
| Expiration Date | 2021-03-31 |
| Refresh Date | 2020-03-27 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 1167400 | CSP.0054825 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 2013-06-07 | 2019-03-01 - 2021-02-28 | ACTIVE |
| 944408 | CSP.0048099 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 2010-07-30 | 2010-07-30 - 2011-02-28 | INACTIVE |
| Street Address | 1835 UNION AVE APT 219 |
| City | MEMPHIS |
| State | TN |
| Zip Code | 38104-3951 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Local Seed Company LLC | 802 Rozell St, Memphis, TN 38104 | Seed Labeler | 2020-04-01 ~ 2021-03-31 |
| Alex Jackson | 1265 Vinton Ave, Memphis, TN 38104 | Professional Engineer | 2020-03-18 ~ 2021-01-31 |
| Scott F Dicus | 1500 Union Ave, Memphis, TN 38104 | Architect | 2003-08-01 ~ 2004-07-31 |
| Roy P Harrover | 39 Belleair Dr, Memphis, TN 38104 | Architect | 2001-08-24 ~ 2002-07-31 |
| Troy W Wallach | 1220 Madison Ave., Memphis, TN 38104 | Registered Nurse | 2007-05-04 ~ 2008-06-30 |
| Mohammad A Ayubi | 1030 Jefferson Ave, Memphis, TN 38104 | Physician/surgeon | 1997-04-28 ~ 1998-06-30 |
| Gregory D Hargett | 1910 Madison Ave, #623, Memphis, TN 38104 | Registered Nurse | 2004-05-27 ~ 2005-06-30 |
| Eben P Bryant | 927 Meda St, Memphis, TN 38104 | Temporary Certified General Real Estate Appraiser | 2000-12-22 ~ 2001-06-12 |
| Liang Zhang | 175 Stonewall St Apt 206, Memphis, TN 38104-2470 | Physician/surgeon | 2020-06-10 ~ 2021-02-28 |
| Larkin M Gieringer | 1603 Vance Ave, Memphis, TN 38104-3834 | Professional Engineer | 2009-02-01 ~ 2010-01-31 |
| Find all Licenses in zip 38104 | |||
| City | MEMPHIS |
| Zip Code | 38104 |
| License Type | Physician/Surgeon |
| License Type + County | Physician/Surgeon + MEMPHIS |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Carissa Marie Monterroso | 2 Park Place 7j, Hartford, CT 06106 | Physician/surgeon | 2019-12-01 ~ 2020-11-30 |
| Webster Lake Variety | 1394 Thompson Rd, Thompson, CT 06277-1322 | Retail Dairy Store | 2019-07-01 ~ 2021-06-30 |
| John M Davis | 442 Webster Ave, Chicago, IL 60614 | Physician/surgeon | 2015-11-01 ~ 2016-10-31 |
| Marian E Serra | 2875 Decker Lake Dr Ste 300, Salt Lake City, UT 84119-2382 | Physician/surgeon | 2020-07-01 ~ 2021-06-30 |
| Bennion D Buchanan | 2875 S. Decker Lake Dr, Salt Lake City, UT 84119-2370 | Physician/surgeon | 2017-09-01 ~ 2018-08-31 |
| Lisa Thottappilly | 2875 Decker Lake Dr # 300, Salt Lake City, UT 84119 | Physician/surgeon | 2019-09-03 ~ 2020-09-30 |
| Dilek Iris Avci | 2875 Decker Lake Dr Ste 300, Salt Lake City, UT 84119-2382 | Physician/surgeon | ~ |
| Margaret Mary Prial | 52 Webster Ave, New Rochelle, NY 10801 | Physician/surgeon | 2019-11-01 ~ 2020-10-31 |
| Mary A Mckendall | 662 Webster Street, Needham, MA 02492 | Physician/surgeon | 2020-08-01 ~ 2021-07-31 |
| Anushree C Shirali Md | 64 Webster Point Rd, Madison, CT 06443-3204 | Physician/surgeon | 2020-06-01 ~ 2021-05-31 |
Please comment or provide details below to improve the information on CARISSA A WEBSTER-LAKE.
| 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).