PAUL GEORGE MARDELLI (Credential# 1615380) 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.
PAUL GEORGE MARDELLI is licensed with the Department of Consumer Protection of Connecticut. The credential number is #1.062235. The credential type is physician/surgeon. The effective date is June 1, 2020. The expiration date is May 31, 2021. The business address is 6711 Liege Hill, Moseley, VA 23120. The current status is active.
| Licensee Name | PAUL GEORGE MARDELLI |
| Credential ID | 1615380 |
| Credential Number | 1.062235 |
| Credential Type | Physician/Surgeon |
| Business Address |
6711 Liege Hill Moseley VA 23120 |
| Business Type | INDIVIDUAL |
| Status | ACTIVE - CURRENT |
| Active | 1 |
| Issue Date | 2019-01-03 |
| Effective Date | 2020-06-01 |
| Expiration Date | 2021-05-31 |
| Refresh Date | 2020-04-13 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 1625085 | CSP.0070077 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 2019-01-10 | 2019-01-10 - 2021-02-28 | ACTIVE |
| Street Address | 6711 Liege Hill |
| City | Moseley |
| State | VA |
| Zip Code | 23120 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Sandra E. Whitton | 4825 Jennway Loop, Moseley, VA 23120 | Certified Public Accountant License | 2020-01-31 ~ 2020-12-31 |
| Stephanie T Bernier | 16318 Faloners Terrace, Moseley, VA 23120 | Registered Nurse | 2010-09-01 ~ 2011-08-31 |
| Linda J Iverson | 16834 Jaydee Teerrace, Moseley, VA 23120 | Registered Nurse | 2008-11-14 ~ 2009-11-30 |
| Kevin F Kokal | 3805 Weatherbury Pl, Moseley, VA 23120-1047 | Professional Engineer | 2020-02-01 ~ 2021-01-31 |
| Richard B Simms | 4212 Tweedsmuir Rd, Moseley, VA 23120-1291 | Professional Engineer | 2020-02-01 ~ 2021-01-31 |
| Britni Ann Nicole Smith Long | 7025 Silk Oak Dr, Moseley, VA 23120-1579 | Registered Nurse - Temporary | 2019-09-27 ~ 2020-01-25 |
| Jennifer Pasquantino | 6213 Lilting Branch Way, Moseley, VA 23120-2231 | Registered Nurse | 2013-07-01 ~ 2014-06-30 |
| Jacqueline Rae Yoder | 16908 Gossamer Dr, Moseley, VA 23120-2321 | Registered Nurse | 2020-05-27 ~ 2020-10-31 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Kristin Michelle Salim | 6213 Gossamer Ter, Moseley, VA 23832 | Registered Nurse | 2020-05-01 ~ 2021-04-30 |
| City | Moseley |
| Zip Code | 23120 |
| License Type | Physician/Surgeon |
| License Type + County | Physician/Surgeon + Moseley |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Paul Eigenberger | 300 George St Ste 901, New Haven, CT 06511-6662 | Resident Physician | 2020-06-11 ~ 2024-06-30 |
| George S Isckarus | George Isckarus, M.d., Joppa, MD 21085 | Physician/surgeon | 2004-12-24 ~ 2006-02-28 |
| George R Lee IIi | 336 22nd Ave N, Nashville, TN 37203-1844 | Physician/surgeon | 2020-01-01 ~ 2020-12-31 |
| George F May | 702 E Hartford Ave, Uxbridge, MA 01569 | Physician/surgeon | 2004-04-05 ~ 2005-04-30 |
| John Hwa | 300 George St Ste 759h, New Haven, CT 06511-6664 | Physician/surgeon | ~ |
| George Gorich | 9 Campus Pl Apt 2b, Scarsdale, NY 10583-1549 | Physician/surgeon | ~ |
| George B Corcoran Jr | Po Box 608, Suffield, CT 06078 | Physician/surgeon | 1994-09-07 ~ 1995-09-30 |
| George J Dirago | 359 N Central Ave, Hartsdale, NY 10530-1811 | Physician/surgeon | ~ |
| Isaac George | 177 Ft. Washing Ave., New York, NY 10032 | Physician/surgeon | ~ |
| George Braff | P.o. Box 157, Lisbon, NH 03585 | Physician/surgeon | 2005-06-29 ~ 2006-08-31 |
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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).