KYLE T ELLIGERS (Credential# 1623111) 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.
KYLE T ELLIGERS is licensed with the Department of Consumer Protection of Connecticut. The credential number is #1.063966. The credential type is physician/surgeon. The effective date is April 1, 2020. The expiration date is March 31, 2021. The business address is 374 Grand Ave, New Haven, CT 06513-3733. The current status is active.
| Licensee Name | KYLE T ELLIGERS |
| Credential ID | 1623111 |
| Credential Number | 1.063966 |
| Credential Type | Physician/Surgeon |
| Business Address |
374 Grand Ave New Haven CT 06513-3733 |
| Business Type | INDIVIDUAL |
| Status | ACTIVE - CURRENT |
| Active | 1 |
| Issue Date | 2019-07-15 |
| Effective Date | 2020-04-01 |
| Expiration Date | 2021-03-31 |
| Refresh Date | 2020-03-17 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 1356306 | CSP.0062838 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 2016-06-09 | 2019-03-01 - 2021-02-28 | ACTIVE |
| 1488451 | 1.057846-RES | Resident Physician | 2016-06-28 | 2016-06-28 - 2019-06-30 | INACTIVE |
| Street Address | 374 GRAND AVE |
| City | NEW HAVEN |
| State | CT |
| Zip Code | 06513-3733 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Jennifer B Yaro | 374 Grand Ave, New Haven, CT 06513-3733 | Advanced Practice Registered Nurse | 2020-04-01 ~ 2021-03-31 |
| Douglas Olson | 374 Grand Ave, New Haven, CT 06513-3733 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Krystn R Wagner | 374 Grand Ave, New Haven, CT 06513-3733 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Eileen F Keane | 374 Grand Ave, New Haven, CT 06513 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Marissa C Bayerl | 374 Grand Ave, New Haven, CT 06513-3733 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Amanda E Decew | 374 Grand Ave, New Haven, CT 06513 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Suzanne P Lagarde | 374 Grand Ave, New Haven, CT 06513-3733 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| James E Seely Md | 374 Grand Ave, New Haven, CT 06513-3733 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Fair Haven Community Health Care | 374 Grand Ave, New Haven, CT 06513-3733 | Substance Abuse | 2018-10-01 ~ 2020-09-30 |
| Fair Haven Community Health Clinic Inc. · Fair Haven Community Health Center | 374 Grand Ave, New Haven, CT 06513-3733 | Outpatient Clinic | 2016-10-01 ~ 2020-09-30 |
| Find all Licenses in the same address | |||
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Nazreat H Teklemicael | 386 Grand Ave # 2r, New Haven, CT 06513-3733 | Family Child Care Home | 2018-12-06 ~ 2022-12-31 |
| Kimberly Westerband | 382 Grand Ave Apt 3l, New Haven, CT 06513-3733 | Pharmacy Technician | 2019-09-17 ~ 2020-03-31 |
| New Haven Pharmacy Inc | 382 Grand Ave, New Haven, CT 06513-3733 | Non Legend Drug Permit | 2020-01-01 ~ 2020-12-31 |
| Sheilla Nortey Asiedu | 382 Grand Ave Apt 21, New Haven, CT 06513-3733 | Licensed Practical Nurse | 2012-01-20 ~ 2012-11-30 |
| Meghanada Yerkam | 382 Grand Ave, New Haven, CT 06513-3733 | Pharmacy Technician | 2019-04-01 ~ 2020-03-31 |
| Zulma O Huerta | 382 Grand Ave, New Haven, CT 06513-3733 | Pharmacy Technician | 2013-10-03 ~ 2014-03-31 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Odalys Guartan | 17 Dell Dr, East Haven, CT 06513 | Combination Nail Technician, Esthetician Or Eyelash Technici | 2020-06-27 ~ 2022-06-30 |
| Marilu E Espinsa | 148 Poplar St, New Haven, CT 06513 | Combination Nail Technician, Esthetician Or Eyelash Technici | ~ |
| Javon Christian Woodard | 404 Poplar St, New Haven, CT 06513 | Registered Nurse | ~ |
| Norma Congacha | 22 Farren Ave., New Haven, CT 06513 | Combination Nail Technician, Esthetician Or Eyelash Technici | 2020-06-27 ~ 2022-05-31 |
| Sonia Sunanita Salazar | 48 Wolcott St 1 L., New Haven, CT 06513 | Combination Nail Technician, Esthetician Or Eyelash Technici | ~ |
| Rosa Zuna | 426 Ferry St. 1st Fl, New Haven, CT 06513 | Combination Nail Technician, Esthetician Or Eyelash Technici | ~ |
| Veronica Congacha | 28 Farren Ave., New Haven, CT 06513 | Combination Nail Technician, Esthetician Or Eyelash Technici | ~ |
| Jessica L Vallejo | 41 Oak Ridge Dr, New Haven, CT 06513 | Combination Nail Technician, Esthetician Or Eyelash Technici | 2020-06-26 ~ 2022-02-28 |
| Ami Nosenzo · Nosenzo | 1423 Quinnipiac Ave, New Haven, CT 06513 | Hairdresser/cosmetician | 2020-07-01 ~ 2022-06-30 |
| Taquetta Delis Mitchell | 40 Foxon Hill Rd I34, New Haven, CT 06513 | Registered Nurse | 2020-07-01 ~ 2021-06-30 |
| Find all Licenses in zip 06513 | |||
| City | NEW HAVEN |
| Zip Code | 06513 |
| License Type | Physician/Surgeon |
| License Type + County | Physician/Surgeon + NEW HAVEN |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Kyle M Gibson | 265 1st Ave Apt 1, New York, NY 10003-2996 | Physician/surgeon | 2015-06-01 ~ 2016-05-31 |
| Kyle T Bramley | 15 York St, New Haven, CT 06510 | Physician/surgeon | 2020-04-01 ~ 2021-03-31 |
| Kyle B Mcclaine | 326 Washington St, Norwich, CT 06360-5634 | Physician/surgeon | 2020-05-01 ~ 2021-04-30 |
| Kyle Shepard | 80 Seymour St, Hartford, CT 06106-3315 | Physician/surgeon | 2020-08-01 ~ 2021-07-31 |
| Donald B Alderman | 733 Kyle Lane, New Haven, CT 06515 | Physician/surgeon | 1993-03-24 ~ 1994-02-28 |
| Kyle Cecil Mciver | 78 Russel Ave, Suffield, CT 06078 | Physician/surgeon | 2020-04-01 ~ 2021-03-31 |
| Anthony Cubb | 2512 Kyle Ct, Columbia, MO 65203-5709 | Physician/surgeon | 1989-07-14 ~ 1990-04-30 |
| Kyle P Nielson | 1300 Boblett St # 374, Blaine, WA 98230-9716 | Physician/surgeon | 2016-02-01 ~ 2017-01-31 |
| Kyle R Vanstone | 8025 Bonhomme Ave Apt 2002, Clayton, MO 63105 | Physician/surgeon | 2014-11-01 ~ 2015-10-31 |
| Kyle J Henneberry Md | 16624 Ne 162nd Court, Woodinville, WA 98072 | Physician/surgeon | 2020-02-01 ~ 2021-01-31 |
Please comment or provide details below to improve the information on KYLE T ELLIGERS.
| 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).