ALEXANDRA STANFORD (Credential# 1653358) is licensed (Resident Physician) with Connecticut Department of Consumer Protection. The license effective date is June 24, 2019. The license expiration date date is July 2, 2023. The license status is ACTIVE.
ALEXANDRA STANFORD is licensed with the Department of Consumer Protection of Connecticut. The credential number is #1.062931-RES. The credential type is resident physician. The effective date is June 24, 2019. The expiration date is July 2, 2023. The business address is 90 South Main St., Middletown, CT 06457. The current status is active.
| Licensee Name | ALEXANDRA STANFORD |
| Credential ID | 1653358 |
| Credential Number | 1.062931-RES |
| Credential Type | Resident Physician |
| Credential SubCategory | RES |
| Business Address |
90 South Main St. Middletown CT 06457 |
| Business Type | INDIVIDUAL |
| Status | ACTIVE - CURRENT |
| Active | 1 |
| Issue Date | 2019-06-24 |
| Effective Date | 2019-06-24 |
| Expiration Date | 2023-07-02 |
| Refresh Date | 2019-05-01 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 1667879 | CSP.0071507 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 2019-06-11 | 2019-06-11 - 2021-02-28 | ACTIVE |
| Street Address | 90 SOUTH MAIN ST. |
| City | MIDDLETOWN |
| State | CT |
| Zip Code | 06457 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Joshua Jones | 90 South Main St., Middletown, CT 06457 | Resident Physician | 2019-06-24 ~ 2023-07-02 |
| Arti Bhukhen | 90 South Main St., Middletown, CT 06457 | Resident Physician | 2019-06-24 ~ 2023-07-02 |
| Gianpaolo Rufo | 90 South Main St., Middletown, CT 06457 | Resident Physician | 2019-06-24 ~ 2023-07-02 |
| Sona Sadselia-patel | 90 South Main St., Middletown, CT 06457 | Resident Physician | 2019-06-24 ~ 2023-07-02 |
| Kalpana Reddy | 90 South Main St., Middletown, CT 06457 | Resident Physician | 2019-06-24 ~ 2023-07-02 |
| Teresa Domack | 90 South Main St., Middletown, CT 06457 | Resident Physician | 2014-06-23 ~ 2018-09-09 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Elizabeth M Mailhot | 177 Timber Ridge Rd, Middletown, CT 06457 | Dental Hygienist | 2020-08-01 ~ 2021-07-31 |
| Rebecca S Fennessy | 22 Keefe Ln, Middletown, CT 06457 | Licensed Clinical Social Worker | 2020-07-01 ~ 2021-06-30 |
| Eloise M Gagnon | 538 Bow Lane, Middletown, CT 06457 | Hairdresser/cosmetician | 2020-08-01 ~ 2022-07-31 |
| Salvatore Dimauro | 245 Dekoven Dr, Middletown, CT 06457 | Public Weigher | 2020-07-01 ~ 2021-06-30 |
| Frank L Wright | 261 Spencer Dr, Middletown, CT 06457 | Barber | 2020-08-01 ~ 2022-07-31 |
| Gino A Cardella | 50 Sonoma Lane, Middletown, CT 06457 | Real Estate Salesperson | ~ |
| Shannon Lee Mcquillan | 5 Forest Glen Circle, Middletown, CT 06457 | Registered Nurse | 2020-06-26 ~ 2020-09-30 |
| Lori Dimauro · Carta | 244 Chamberlain Hill Road, Middletown, CT 06457 | Hairdresser/cosmetician | 2020-09-01 ~ 2022-08-31 |
| Gail A Corrow | 85 Dora Dr, Middletown, CT 06457 | Real Estate Salesperson | 2020-06-01 ~ 2021-05-31 |
| Mariter V Perez | 8 Moss Glen, Middletown, CT 06457 | Registered Nurse | 2020-08-01 ~ 2021-07-31 |
| Find all Licenses in zip 06457 | |||
| City | MIDDLETOWN |
| Zip Code | 06457 |
| License Type | Resident Physician |
| License Type + County | Resident Physician + MIDDLETOWN |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Ivan J Stanford | 263 Farmington Ave, Farmington, CT 06030-0001 | Resident Physician | 2019-06-28 ~ 2022-06-30 |
| Alexandra Carlson | 90 S Main St, Middletown, CT 06457-3649 | Resident Physician | 2018-06-25 ~ 2022-07-03 |
| Alexandra Dubinskaya | 114 Woodland St, Hartford, CT 06105-1208 | Resident Physician | 2017-06-20 ~ 2020-06-30 |
| Alexandra J Loza | 1 Linden Pl Apt 401, Hartford, CT 06106-1745 | Resident Physician | 2020-07-01 ~ 2023-06-30 |
| Alexandra Schwann | 20 York St, New Haven, CT 06510-3220 | Resident Physician | 2020-06-11 ~ 2021-06-30 |
| Alexandra Menillo | 20 York St, New Haven, CT 06510 | Resident Physician | 2020-03-09 ~ 2020-04-05 |
| Alexandra Maria Lesenskyj | 20 York St, New Haven, CT 06510-3220 | Resident Physician | 2020-06-15 ~ 2021-06-30 |
| Alexandra C Sloan | 48 Stanford Rd, Millbrook, NY 12545-5605 | Architect | 2020-08-01 ~ 2021-07-31 |
| Alexandra Michelle Laps | 1245 Chapel St Apt 622, New Haven, CT 06511-4660 | Resident Physician | 2020-06-08 ~ 2021-06-30 |
| Renata Alexandra Bajaj | 20 York Street, New Haven, CT 06510 | 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).