JAN EHRENWERTH MD (Credential# 545425) is licensed (Physician/surgeon) with Connecticut Department of Consumer Protection. The license effective date is May 1, 2020. The license expiration date date is April 30, 2021. The license status is ACTIVE.
JAN EHRENWERTH MD is licensed with the Department of Consumer Protection of Connecticut. The credential number is #1.025349. The credential type is physician/surgeon. The effective date is May 1, 2020. The expiration date is April 30, 2021. The business address is 4 Randi Drive, Madison, CT 06443. The current status is active.
| Licensee Name | JAN EHRENWERTH MD |
| Business Name | YALE UNIVERSITY SCHOOL OF MEDICINE |
| Credential ID | 545425 |
| Credential Number | 1.025349 |
| Credential Type | Physician/Surgeon |
| Business Address |
4 Randi Drive Madison CT 06443 |
| Business Type | INDIVIDUAL |
| Status | ACTIVE - CURRENT |
| Active | 1 |
| Issue Date | 1984-04-06 |
| Effective Date | 2020-05-01 |
| Expiration Date | 2021-04-30 |
| Refresh Date | 2020-03-02 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 149044 | CSP.0012265 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 1999-03-01 | 2019-03-01 - 2021-02-28 | ACTIVE |
| Street Address | 4 RANDI DRIVE |
| City | MADISON |
| State | CT |
| Zip Code | 06443 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Mary Ann Ehrenwerth | 4 Randi Drive, Madison, CT 06443 | Registered Nurse | 2020-03-01 ~ 2021-02-28 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Caitlyn Beverly Darosa | Lyle Dr, Madison, CT 06443 | Registered Nurse | ~ |
| Roberts Food Center · Rjf Inc Dba | 514 Old Toll Rd, Madison, CT 06443 | Operator of Weighing & Measuring Devices | 2020-08-01 ~ 2021-07-31 |
| Karen D Leonetti · Rapuano | 553 Green Hill Rd, Madison, CT 06443 | Radiographer | 2020-09-01 ~ 2021-08-31 |
| Pasquale Sabatasso | 122 River Edge Farms Road, Madison, CT 06443 | Barber | 2020-07-01 ~ 2022-06-30 |
| Madision Health Foods · Jum Ok Coker | 59 Wall St, Madison, CT 06443 | Operator of Weighing & Measuring Devices | 2020-08-01 ~ 2021-07-31 |
| Madison Community Services Inc. | P.o. Box 148, Madison, CT 06443 | Public Charity | 2020-12-01 ~ 2021-11-30 |
| Shaina Michele Levinson | 52 East Wharf Rd, Madison, CT 06443 | Master's Level Social Worker | ~ |
| Stephen G Lynch · Lynch, Stephen Gerard | 12 Milestone Lane, Madison, CT 06443 | Real Estate Salesperson | 2020-06-01 ~ 2021-05-31 |
| David F Courtney Md | 38 Old Duck Hole Road, Madison, CT 06443 | Physician/surgeon | 2020-07-01 ~ 2021-06-30 |
| Sydni E Marmor | 560 Opening Hill Road, Madison, CT 06443 | Professional Counselor | 2020-07-01 ~ 2021-06-30 |
| Find all Licenses in zip 06443 | |||
| City | MADISON |
| Zip Code | 06443 |
| License Type | Physician/Surgeon |
| License Type + County | Physician/Surgeon + MADISON |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Yale University School of Medicine · Michele Solimena | Dept of Internal Medicine, New Haven, CT 06520 | Controlled Substance Laboratory | 2001-02-01 ~ 2002-01-31 |
| Yale University School of Medicine · Ning Tian Md Phd | 330 Cedar St Bml 212 Yale, New Haven, CT 06520 | Controlled Substance Laboratory | 2002-02-01 ~ 2003-01-31 |
| Yale University School of Medicine · Barbara E Scanley | Diagnostic Radiology Fitkin B, New Haven, CT 06510 | Controlled Substance Laboratory | 2001-02-01 ~ 2002-01-31 |
| Yale University School of Medicine · Dr.diane Mcmahon Pratt | 60 College St, New Haven, CT 06520-8034 | Controlled Substance Laboratory | ~ |
| Yale University School of Medicine · Lab of Caren Gundberg Prof. | 330 Cedar St, New Haven, CT 06510-3218 | Controlled Substance Laboratory | ~ |
| Yale University School of Medicine · Ravinder Nath | 15 York Street, New Haven, CT 06510 | Controlled Substance Laboratory | 2012-02-01 ~ 2013-01-31 |
| Yale University School of Medicine · Michael Lidow Phd | Neurobiology Dept, New Haven, CT 06510 | Controlled Substance Laboratory | 1996-01-05 ~ 1997-01-31 |
| Yale University School of Medicine · Christopher K Breuer | 10 Amistad Street, New Haven, CT 06520-8062 | Controlled Substance Laboratory | 2012-02-01 ~ 2013-01-31 |
| Yale University School of Medicine · Mary Klein | 165 Prospect Street, New Haven, CT 06510 | Controlled Substance Laboratory | 2012-02-08 ~ 2013-01-31 |
| Yale University School of Medicine · John Krystal | 801 Howard Avenue, New Haven, CT 06510 | Controlled Substance Laboratory | 2012-02-01 ~ 2013-01-31 |
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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).