SALLY R BERGWERK (Credential# 544973) is licensed (Physician/surgeon) with Connecticut Department of Consumer Protection. The license effective date is August 1, 2020. The license expiration date date is July 31, 2021. The license status is ACTIVE.
SALLY R BERGWERK is licensed with the Department of Consumer Protection of Connecticut. The credential number is #1.024336. The credential type is physician/surgeon. The effective date is August 1, 2020. The expiration date is July 31, 2021. The business address is 35 Old Ridgefield Road, Wilton, CT 06897. The current status is active.
| Licensee Name | SALLY R BERGWERK |
| Credential ID | 544973 |
| Credential Number | 1.024336 |
| Credential Type | Physician/Surgeon |
| Business Address |
35 Old Ridgefield Road Wilton CT 06897 |
| Business Type | INDIVIDUAL |
| Status | ACTIVE - CURRENT |
| Active | 1 |
| Issue Date | 1983-03-24 |
| Effective Date | 2020-08-01 |
| Expiration Date | 2021-07-31 |
| Refresh Date | 2020-06-03 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 153248 | CSP.0011372 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 1999-03-01 | 2019-03-01 - 2021-02-28 | ACTIVE |
| Street Address | 35 OLD RIDGEFIELD ROAD |
| City | WILTON |
| State | CT |
| Zip Code | 06897 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Thomas Patrick Coyne Jr | 35 Old Ridgefield Road, Wilton, CT 06897 | Certified Public Accountant License | 2020-01-01 ~ 2020-12-31 |
| Ira P. P. Hersh | 35 Old Ridgefield Road, Wilton, CT 06897 | Tax Preparer/facilitator Permit | 2018-12-15 ~ 2020-12-31 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Nicole Adara Case | 14 Middlebrook Farm Rd, Wilton, CT 06897 | Emergency Medical Technician | ~ |
| C B Tart | 105 Seeley Road, Wilton, CT 06897 | Registered Nurse | 2020-08-01 ~ 2021-07-31 |
| Matthew P Schmitt | 116 Borglum Rd, Wilton, CT 06897 | Home Improvement Contractor | 2020-06-18 ~ 2020-11-30 |
| Music On The Hill Inc | 48 New Canaan Road, Wilton, CT 06897 | Public Charity | 2020-12-01 ~ 2021-11-30 |
| Neelam Narula | 11 Glen Ridge, Wilton, CT 06897 | Advanced Practice Registered Nurse | 2020-09-01 ~ 2021-08-31 |
| Katherine S Lewis | 43 Antler Lane, Wilton, CT 06897 | Registered Nurse | 2020-08-01 ~ 2021-07-31 |
| Steven Phillips | 944 Danbury Rd, Wilton, CT 06897 | Physician/surgeon | 2020-08-01 ~ 2021-07-31 |
| Sally S Chao Md | 48 Saint Johns Rd, Wilton, CT 06897 | Physician/surgeon | 2020-09-01 ~ 2021-08-31 |
| Christine M Tenore | 150 St Johns Road, Wilton, CT 06897 | Notary Public Appointment | 2020-10-01 ~ 2025-09-30 |
| Susan Lee | 200 Danbury Road, Apt 5, Wilton, CT 06897 | Hairdresser/cosmetician | 2020-08-01 ~ 2022-07-31 |
| Find all Licenses in zip 06897 | |||
| City | WILTON |
| Zip Code | 06897 |
| License Type | Physician/Surgeon |
| License Type + County | Physician/Surgeon + WILTON |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Sally Irons Md | 540 Saybrook Rd, Middletown, CT 06457 | Physician/surgeon | 2020-07-01 ~ 2021-06-30 |
| Sally A Rudicel | 19 Islington Rd., Auburndale, MA 02466 | Physician/surgeon | 2011-08-01 ~ 2012-07-31 |
| Sally L Marchesi | 179 Prospect Ave, Guilford, CT 06437 | Physician/surgeon | 1997-02-13 ~ 1998-04-30 |
| Sally E Shaywitz Md | Dept of Pediatrics, New Haven, CT 06520-8064 | Physician/surgeon | 2020-04-01 ~ 2021-03-31 |
| Sally Crawford | 13 Clark Lane, Essex, CT 06426 | Physician/surgeon | 2020-05-01 ~ 2021-04-30 |
| Sally C Guimaraes | 9 Estes Drive, Freeport, ME 04032 | Physician/surgeon | 1993-08-25 ~ 1994-09-30 |
| Sally S Chao Md | 48 Saint Johns Rd, Wilton, CT 06897 | Physician/surgeon | 2020-09-01 ~ 2021-08-31 |
| Sally A Ardolino | 12 Thomas Drive, Scarborough, ME 04074 | Physician/surgeon | 2014-12-01 ~ 2015-11-30 |
| Sally Tanakchi | 5225 Pooks Hill Rd, Bethesda, MD 20814 | Physician/surgeon | 2018-12-24 ~ 2019-11-30 |
| Sally J Compere | 10726 Glen Acres Dr S, Seattle, WA 98168-1555 | Physician/surgeon | 2019-06-01 ~ 2020-05-31 |
Please comment or provide details below to improve the information on SALLY R BERGWERK.
| 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).