JAMES PRESTON EBAUGH (Credential# 2044134) is licensed (Resident Physician) with Connecticut Department of Consumer Protection. The license effective date is July 1, 2020. The license expiration date date is June 30, 2021. The license status is ACTIVE.
JAMES PRESTON EBAUGH is licensed with the Department of Consumer Protection of Connecticut. The credential number is #1.065490-RES. The credential type is resident physician. The effective date is July 1, 2020. The expiration date is June 30, 2021. The business address is 360 State St Apt 2118, New Haven, CT 06510-3620. The current status is active.
| Licensee Name | JAMES PRESTON EBAUGH |
| Credential ID | 2044134 |
| Credential Number | 1.065490-RES |
| Credential Type | Resident Physician |
| Credential SubCategory | RES |
| Business Address |
360 State St Apt 2118 New Haven CT 06510-3620 |
| Business Type | INDIVIDUAL |
| Status | ACTIVE - CURRENT |
| Active | 1 |
| Issue Date | 2020-07-01 |
| Effective Date | 2020-07-01 |
| Expiration Date | 2021-06-30 |
| Refresh Date | 2020-05-12 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 2047091 | CSP.0074097 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 2020-05-21 | 2020-05-21 - 2021-02-28 | ACTIVE |
| 2032336 | 1 | Physician/Surgeon | - | PENDING |
| Street Address | 360 STATE ST APT 2118 |
| City | NEW HAVEN |
| State | CT |
| Zip Code | 06510-3620 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Marina Heskel | 360 State St Apt 2115, New Haven, CT 06510-3620 | Resident Physician | 2020-06-11 ~ 2021-06-30 |
| Talib Dosani | 360 State St Apt 2109, New Haven, CT 06510-3620 | Resident Physician | 2018-07-01 ~ 2021-06-30 |
| Caroline A Walker | 360 State St Apt 2110, New Haven, CT 06510-3620 | Resident Physician | 2018-07-01 ~ 2021-06-30 |
| Sirish Kumar Kondabolu | 360 State St Apt 2106, New Haven, CT 06510-3620 | Controlled Substance Registration for Practitioner | 2019-10-17 ~ 2021-02-28 |
| Bing Xia | 360 State St Apt 1813, New Haven, CT 06510-3620 | Resident Physician | 2014-06-23 ~ 2020-06-30 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Gary P Bernardi Jr | Yale New Haven Hospital, New Haven, CT 06510 | Advanced Practice Registered Nurse | 2020-07-01 ~ 2021-06-30 |
| Katherine G Kennedy | 65 Trumbull St, New Haven, CT 06510 | Physician/surgeon | 2020-07-01 ~ 2021-06-30 |
| Molly Elizabeth Mcadow | 333 Cedar Street, New Haven, CT 06510 | Physician/surgeon | 2020-07-01 ~ 2021-06-30 |
| Brady Dunkle | 58 Vernon Street, New Haven, CT 06510 | Registered Nurse | ~ |
| Karin Ann Price | 20 York St, New Haven, Ct 06510, New Haven, CT 06510 | Registered Nurse - Temporary | 2020-06-25 ~ 2020-10-23 |
| G C S Constuction LLC | 142 Temple Street, New Haven, CT 06510 | Major Contractor | 2020-07-01 ~ 2021-06-30 |
| Paul L Mccarthy Md · Yale School of Medicine | Dept of Pediatrics, New Haven, CT 06510 | Physician/surgeon | 2020-09-01 ~ 2021-08-31 |
| Lauren E Cohn Md | Yale New-haven Hospital, New Haven, CT 06510 | Physician/surgeon | 2020-07-01 ~ 2021-06-30 |
| Bong Francois | 900 Chapel St Apt 901, New Haven, CT 06510 | Combination Nail Technician, Esthetician Or Eyelash Technici | ~ |
| Pelli Clarke Pelli Architects Inc. | 1056 Chapel St, New Haven, CT 06510 | Architecture Corporation | 2020-08-01 ~ 2021-07-31 |
| Find all Licenses in zip 06510 | |||
| City | NEW HAVEN |
| Zip Code | 06510 |
| License Type | Resident Physician |
| License Type + County | Resident Physician + NEW HAVEN |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Duane W Ebaugh | 1703 West Main St., Willimantic, CT 06226 | Physician/surgeon | ~ 1995-06-30 |
| James Gusfa Md | Po Box 351, Middletown, CT 06457-7023 | Resident Physician | 2014-08-21 ~ 2021-06-30 |
| James T O'neill IIi | 260 Cabin Rd, Colchester, CT 06415-1505 | Resident Physician | 2018-04-09 ~ 2018-05-06 |
| Max James Biondi | 20 York St, New Haven, CT 06510-3220 | Resident Physician | 2020-07-01 ~ 2021-06-30 |
| James H Kurfess | 20 York St, New Haven, CT 06510-3220 | Resident Physician | 2020-07-01 ~ 2021-06-30 |
| James Nugent | 20 York St, New Haven, CT 06510 | Resident Physician | 2020-07-05 ~ 2021-06-30 |
| Efia S James | 20 York St, New Haven, CT 06510-3220 | Resident Physician | 2017-07-01 ~ 2021-06-30 |
| James B Gardner | 129 Jordan Ln, Stamford, CT 06903-3913 | Resident Physician | 2020-01-10 ~ 2021-06-30 |
| James S Farrelly | 24 Bayberry Ln, Milford, CT 06460-6561 | Resident Physician | 2020-08-01 ~ 2021-06-30 |
| James Lee Baier | 300 George St Ste 901, New Haven, CT 06511-6662 | Resident Physician | 2018-06-11 ~ 2022-06-30 |
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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).