MAMADOU SANOGO
Resident Physician


Address: 5425 Connecticut Ave Nw Apt 519, Washington, DC 20015-2726

MAMADOU SANOGO (Credential# 1490958) is licensed (Resident Physician) with Connecticut Department of Consumer Protection. The license effective date is July 1, 2016. The license expiration date date is June 30, 2019. The license status is INACTIVE.

Business Overview

MAMADOU SANOGO is licensed with the Department of Consumer Protection of Connecticut. The credential number is #1.059060-RES. The credential type is resident physician. The effective date is July 1, 2016. The expiration date is June 30, 2019. The business address is 5425 Connecticut Ave Nw Apt 519, Washington, DC 20015-2726. The current status is inactive.

Basic Information

Licensee Name MAMADOU SANOGO
Credential ID 1490958
Credential Number 1.059060-RES
Credential Type Resident Physician
Credential SubCategory RES
Business Address 5425 Connecticut Ave Nw Apt 519
Washington
DC 20015-2726
Business Type INDIVIDUAL
Status INACTIVE - INACTIVE
Issue Date 2016-07-01
Effective Date 2016-07-01
Expiration Date 2019-06-30
Refresh Date 2019-07-01

Other licenses

ID Credential Code Credential Type Issue Term Status
1351642 CSP.0062572 CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER 2016-05-05 2017-03-01 - 2019-02-28 LAPSED
1125247 CSP.0053799 CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER 2012-10-03 2013-03-01 - 2015-02-28 INACTIVE

Office Location

Street Address 5425 CONNECTICUT AVE NW APT 519
City WASHINGTON
State DC
Zip Code 20015-2726

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David A Bauman 5335 Wisconsin Ave Nw #850, Washington, DC 20015 Student Athlete Agent 2008-04-11 ~ 2009-12-31
Kathleen A Mitchell 3611 Jenifer St Nw, Washington, DC 20015 Registered Nurse 1992-05-27 ~ 1993-04-30
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Competitor

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City WASHINGTON
Zip Code 20015
License Type Resident Physician
License Type + County Resident Physician + WASHINGTON

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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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