JUSTIN EGLSEDER (Credential# 1509585) is licensed (Resident Physician) with Connecticut Department of Consumer Protection. The license effective date is July 1, 2018. The license expiration date date is June 30, 2021. The license status is ACTIVE.
JUSTIN EGLSEDER is licensed with the Department of Consumer Protection of Connecticut. The credential number is #1.060437-RES. The credential type is resident physician. The effective date is July 1, 2018. The expiration date is June 30, 2021. The business address is 1351 Washington Blvd, Stamford, CT 06902-2419. The current status is active.
| Licensee Name | JUSTIN EGLSEDER |
| Credential ID | 1509585 |
| Credential Number | 1.060437-RES |
| Credential Type | Resident Physician |
| Credential SubCategory | RES |
| Business Address |
1351 Washington Blvd Stamford CT 06902-2419 |
| Business Type | INDIVIDUAL |
| Status | ACTIVE - CURRENT |
| Active | 1 |
| Issue Date | 2018-07-01 |
| Effective Date | 2018-07-01 |
| Expiration Date | 2021-06-30 |
| Refresh Date | 2018-06-20 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 1634015 | CSP.0070318 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 2019-03-08 | 2019-03-08 - 2021-02-28 | ACTIVE |
| Street Address | 1351 WASHINGTON BLVD |
| City | STAMFORD |
| State | CT |
| Zip Code | 06902-2419 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Katherine Vaillancourt | 1351 Washington Blvd, Stamford, CT 06902-2419 | Resident Physician | 2020-07-01 ~ 2023-06-30 |
| Rosario Giacomini | 1351 Washington Blvd, Stamford, CT 06904 | Resident Physician | 2020-07-01 ~ 2023-06-30 |
| Domenic Termine | 1351 Washington Blvd, Stamford, CT 06904 | Resident Physician | 2020-07-01 ~ 2023-06-30 |
| Matthew Scott | 1351 Washington Blvd, Stamford, CT 06904 | Resident Physician | 2020-07-01 ~ 2023-06-30 |
| Katherine Mathew | 1351 Washington Blvd, Stamford, CT 06904 | Resident Physician | 2020-07-01 ~ 2023-06-30 |
| Optimus Health Care, Inc. | 1351 Washington Blvd, Stamford, CT 06902-2419 | Psychiatric Outpatient Clinic | 2019-07-01 ~ 2023-06-30 |
| Meghan Veno | 1351 Washington Blvd, Stamford, CT 06902-2419 | Resident Physician | 2019-07-01 ~ 2022-06-30 |
| Emilie Leroy | 1351 Washington Blvd, Stamford, CT 06902-2419 | Resident Physician | 2019-07-01 ~ 2022-06-30 |
| Shelja Patel | 1351 Washington Blvd, Stamford, CT 06902-2419 | Resident Physician | 2019-07-01 ~ 2022-06-30 |
| Kristen Colavita | 1351 Washington Blvd, Stamford, CT 06902-2419 | Resident Physician | 2019-07-01 ~ 2022-06-30 |
| Find all Licenses in the same address | |||
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Jeris Maydeli Flores | 153 Fairfield Av, Stamford, CT 06902 | Nail Technician | ~ |
| Reynaldo De La Cruz | 64 Brookside Drive, Stamford, CT 06902 | Registered Nurse | 2020-08-01 ~ 2021-07-31 |
| Darren J Petillo | 5 Hundley Court, Stamford, CT 06902 | Licensed Clinical Social Worker | 2020-09-01 ~ 2021-08-31 |
| Antonios Restaurant | 405 West Main St, Stamford, CT 06902 | Bakery | 2020-07-01 ~ 2021-06-30 |
| Edward Smith | 184 Fairfield Ave., Stamford, CT 06902 | Home Improvement Contractor | ~ |
| Margaret A Dorrance | 24c Hamilton Court, Stamford, CT 06902 | Registered Nurse | 2020-07-01 ~ 2021-06-30 |
| Carolyn Maguire | 48 Nelson St, Stamford, CT 06902 | Registered Nurse | 2020-07-01 ~ 2021-06-30 |
| Evelyne Joassin | 17 George St., Stamford, CT 06902 | Licensed Practical Nurse | 2020-07-01 ~ 2021-06-30 |
| Andrea Bynoe | 34 Melrose Pl, Stamford, CT 06902 | Notary Public Appointment | 1994-04-06 ~ 1999-04-30 |
| Ravi K Ahuja | 296 Westover Rd, Stamford, CT 06902 | Architect | 2020-08-01 ~ 2021-07-31 |
| Find all Licenses in zip 06902 | |||
| City | STAMFORD |
| Zip Code | 06902 |
| License Type | Resident Physician |
| License Type + County | Resident Physician + STAMFORD |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Justin Kuether | 139 Treadwell St, Hamden, CT 06517-2342 | Resident Physician | 2020-07-01 ~ 2021-06-30 |
| Justin Young | 300 George St Ste 901, New Haven, CT 06511-6662 | Resident Physician | 2020-06-11 ~ 2024-06-30 |
| Justin R Marcus | 360 State St Apt 716, New Haven, CT 06510-3603 | Resident Physician | 2014-07-07 ~ 2020-06-30 |
| Justin Keele Banerdt | 20 York St Rm 226, New Haven, CT 06510-3220 | Resident Physician | 2020-06-11 ~ 2021-06-30 |
| Justin Michael Pacor | 123 York St, New Haven, CT 06511-5655 | Resident Physician | 2020-07-01 ~ 2021-06-30 |
| Justin Van Minh Nguyen | 100 Temple St Ph 17, New Haven, CT 06510-2711 | Resident Physician | 2020-07-01 ~ 2021-06-30 |
| Justin Alexander Charles | C/o 20 York St, New Haven, CT 06510 | Resident Physician | 2020-07-01 ~ 2021-06-30 |
| Adam Justin Parker | 300 George St Ste 901, New Haven, CT 06511-6662 | Resident Physician | 2019-06-24 ~ 2021-06-30 |
| Justin Mark Le Blanc | 62 Toledo Ave, Warwick, RI 02888-4133 | Resident Physician | 2020-07-01 ~ 2021-06-30 |
| Justin Swank | 263 Farmington Ave, Farmington, CT 06030-0001 | Resident Physician | 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).