LESLIE JACOBSEN MD (Credential# 548790) is licensed (Physician/surgeon) 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.
LESLIE JACOBSEN MD is licensed with the Department of Consumer Protection of Connecticut. The credential number is #1.030919. The credential type is physician/surgeon. The effective date is July 1, 2020. The expiration date is June 30, 2021. The business address is 45 Reservoir St, New Haven, CT 06511. The current status is active.
| Licensee Name | LESLIE JACOBSEN MD |
| Credential ID | 548790 |
| Credential Number | 1.030919 |
| Credential Type | Physician/Surgeon |
| Business Address |
45 Reservoir St New Haven CT 06511 |
| Business Type | INDIVIDUAL |
| Status | ACTIVE - CURRENT |
| Active | 1 |
| Issue Date | 1990-07-06 |
| Effective Date | 2020-07-01 |
| Expiration Date | 2021-06-30 |
| Refresh Date | 2020-05-21 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 181756 | CSP.0025393 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 2011-03-01 - 2013-02-28 | INACTIVE | |
| 159781 | CSP.0020267 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 1993-11-03 - 1995-12-01 | INACTIVE |
| Street Address | 45 RESERVOIR ST |
| City | NEW HAVEN |
| State | CT |
| Zip Code | 06511 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Montessori School On Edgewood Inc. | 230 Edgewood Avenue, New Haven, CT 06511 | Public Charity | 2019-06-01 ~ 2020-05-31 |
| Therese Parks · Visel Drug Store | 264 Munson St, New Haven, CT 06511 | Registered Nurse | 2020-07-01 ~ 2021-06-30 |
| Dazjia Monet Green | 115 Edgewood Ave Apt 64, New Haven, CT 06511 | Registered Nurse | 2020-06-27 ~ 2021-05-31 |
| Carol Yam | 343 Humphrey St, New Haven, CT 06511 | Registered Nurse | ~ |
| Marwan S Haddad | 38 Lincoln Street, New Haven, CT 06511 | Physician/surgeon | 2020-07-01 ~ 2021-06-30 |
| Mary Lou Gaeta Md | 558 Chapel Street, New Haven, CT 06511 | Physician/surgeon | 2020-07-01 ~ 2021-06-30 |
| Cary M Tucker | 64 Bishop St, New Haven, CT 06511 | Architect | 2020-08-01 ~ 2021-07-31 |
| Frank J Pannenborg | 505 Ellsworth Ave, New Haven, CT 06511 | Architect | 2020-08-01 ~ 2021-07-31 |
| Crystal E Gooding | 26 Woodland Street, New Haven, CT 06511 | Notary Public Appointment | 2020-07-01 ~ 2025-06-30 |
| Kieran Jones | 260 Crown St Unit 1f, New Haven, CT 06511 | Registered Nurse | ~ |
| Find all Licenses in zip 06511 | |||
| City | NEW HAVEN |
| Zip Code | 06511 |
| License Type | Physician/Surgeon |
| License Type + County | Physician/Surgeon + NEW HAVEN |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Eric Jacobsen · Jacobsen Design & Consulting | 32 Clark Rd, Lyme, CT 06371-3007 | Architect | 2020-08-01 ~ 2021-07-31 |
| Carol V Jacobsen · Jacobsen | 48 Brentwood Drive, Avon, CT 06001 | Registered Nurse | 2002-08-07 ~ 2003-08-31 |
| Bay Jacobsen Usa Inc | 196 Woodlawn Road, Berlin, CT 06037 | Manufacturer of Bedding & Upholstered Furniture | 1994-07-16 ~ 1995-07-16 |
| Lloyd A Jacobsen · Jacobsen Builders | 18 Center St, Brewster, NY 10509 | Home Improvement Contractor | 2000-12-07 ~ 2001-11-30 |
| Robert F Jacobsen · Rf Jacobsen | 2160 Charlotte Amalie Ct, Punta Gorda, FL 33950 | Professional Engineer | 1993-12-24 ~ 1995-01-31 |
| Michael Jacobsen · Jacobsen Building and Remodeling | 164 Shenipsit Lake Rd, Tolland, CT 06084 | Home Improvement Contractor | 2020-03-04 ~ 2020-11-30 |
| Leslie Coopersmith | 133 Scovill St. Ste. 101, Waterbury, CA 06706 | Physician/surgeon | ~ |
| Leslie M. Rickey | 25 Alston Ave, New Haven, CT 06515-2702 | Physician/surgeon | 2020-06-01 ~ 2021-05-31 |
| Leslie C Huff | 258 Main St Ste 208, Milford, MA 01757-2506 | Physician/surgeon | 2019-12-01 ~ 2020-11-30 |
| Leslie M Israel | 8 Cerrito, Irvine, CA 92612 | Physician/surgeon | 2015-04-01 ~ 2016-03-31 |
Please comment or provide details below to improve the information on LESLIE JACOBSEN MD.
| 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).