WENDY A MILLER (Credential# 558034) is licensed (Physician/surgeon) with Connecticut Department of Consumer Protection. The license effective date is June 1, 2020. The license expiration date date is May 31, 2021. The license status is ACTIVE.
WENDY A MILLER is licensed with the Department of Consumer Protection of Connecticut. The credential number is #1.040451. The credential type is physician/surgeon. The effective date is June 1, 2020. The expiration date is May 31, 2021. The business address is Mc1921 Farmington Ave # 263, Farmington, CT 06030-0001. The current status is active.
| Licensee Name | WENDY A MILLER |
| Credential ID | 558034 |
| Credential Number | 1.040451 |
| Credential Type | Physician/Surgeon |
| Business Address |
Mc1921 Farmington Ave # 263 Farmington CT 06030-0001 |
| Business Type | INDIVIDUAL |
| Status | ACTIVE - CURRENT |
| Active | 1 |
| Issue Date | 2002-05-22 |
| Effective Date | 2020-06-01 |
| Expiration Date | 2021-05-31 |
| Refresh Date | 2020-06-24 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 307175 | CSP.0032112 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 2002-05-28 | 2019-03-01 - 2021-02-28 | ACTIVE |
| Street Address | MC1921 FARMINGTON AVE # 263 |
| City | FARMINGTON |
| State | CT |
| Zip Code | 06030-0001 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Jason J Ziegler | 2 Courthouse Square, Farmington, CT 06030-0001 | Real Estate Salesperson | 2020-06-01 ~ 2021-05-31 |
| Bryden T Considine | L2104 of Medicine Rm, Farmington, CT 06030-0001 | Resident Physician | 2017-07-03 ~ 2021-06-30 |
| Dillon Paulo | 4260 Cordoba Ct, Farmington, CT 06030-0001 | Resident Physician | 2020-07-01 ~ 2024-06-30 |
| Erica Shen Nofziger | 263 Farmington Ave, Farmington, CT 06030-0001 | Resident Physician | 2020-07-01 ~ 2027-06-30 |
| Omar Ibrahim | 263 Farmington Ave # Mc-1321, Farmington, CT 06030-0001 | Physician/surgeon | 2020-06-01 ~ 2021-05-31 |
| Jillian L Fortier | Uconn Health Center, Department of Surgery, Farmington, CT 06030-0001 | Physician/surgeon | 2020-05-01 ~ 2021-04-30 |
| Douglas Zelisko | 263 Farmington Ave Dept Of, Farmington, CT 06030-0001 | Physician/surgeon | 2020-04-23 ~ 2021-01-31 |
| Ruchir D Trivedi | 263 Farmington Ave # Mc-1405, Farmington, CT 06030-0001 | Physician/surgeon | 2020-06-01 ~ 2021-05-31 |
| Rawan J.j. Sarsour | 263 Farmington Ave # Mc3905, Farmington, CT 06030-0001 | Provisional Faculty Dentist | 2020-04-21 ~ 2021-04-30 |
| Angela Hart | General Medicine- Outpatient Pavilion, Farmington, CT 06030-0001 | Physician/surgeon | 2020-05-01 ~ 2021-04-30 |
| Find all Licenses in zip 06030-0001 | |||
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Eric Anthony Brueckner | 263 Farmington Ave., Farmington, CT 06030 | Physician/surgeon | 2020-08-01 ~ 2021-07-31 |
| Derrick B Bremang | Residency Program, Farmington, CT 06030 | Physician/surgeon | 2020-06-01 ~ 2021-06-30 |
| David M Shafer | Uconn Health Center, Farmington, CT 06030 | Dentist | 2020-07-01 ~ 2021-06-30 |
| Michael J Murphy | Dept of Dermatology, Farmington, CT 06030 | Physician/surgeon | 2020-09-01 ~ 2021-08-31 |
| Richard F Kaplan | Univ. of Ct., Farmington, CT 06030 | Psychologist | 2020-06-01 ~ 2021-05-31 |
| Nicholas George Vitale | 22 Woods Drive, Norwich, CT 06030 | Casino Class I Employee | 2019-12-03 ~ 2020-10-31 |
| Bruce E Gould | Univ of Conn Health Center, Farmington, CT 06030 | Physician/surgeon | 2020-04-01 ~ 2021-03-31 |
| Vinayak M Sathe | Uconn Health Center,263 Farmington Ave, Farmington, CT 06030 | Physician/surgeon | 2020-06-01 ~ 2021-05-31 |
| Shobhana Pathani | Department of Medicine, 263 Farmington Ave, CT 06030 | Physician/surgeon | 2020-06-01 ~ 2021-05-31 |
| Patricia L Almeida | John Dempsey Hospital, Farmington, CT 06030 | Registered Nurse | 2020-04-01 ~ 2021-03-31 |
| Find all Licenses in zip 06030 | |||
| City | FARMINGTON |
| Zip Code | 06030 |
| License Type | Physician/Surgeon |
| License Type + County | Physician/Surgeon + FARMINGTON |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Wendy E Cohen | Po Box 588, Englewood, NJ 07631 | Physician/surgeon | 2010-04-01 ~ 2011-03-31 |
| Wendy Decter | 144 Rowland Rd, Fairfield, CT 06824-6623 | Physician/surgeon | 2012-01-01 ~ 2012-12-31 |
| Wendy Leung | 310 Cedar St Fmb 320, New Haven, CT 06510-3218 | Physician/surgeon | 2020-07-01 ~ 2021-06-30 |
| Wendy L Stiles | 506 W Holly St, Phoenix, AZ 85003-1119 | Physician/surgeon | 2009-10-01 ~ 2010-09-30 |
| Wendy J Hanafee Md | Clearwater Beach, FL 33767 | Physician/surgeon | 2016-12-01 ~ 2017-11-30 |
| Wendy Amblo Md | 50 Colony Rd, W Hartford, CT 06117 | Physician/surgeon | 2019-12-01 ~ 2020-11-30 |
| Wendy M Maki | 96 Danbury Rd, Ridgefield, CT 06877 | Physician/surgeon | 2020-04-01 ~ 2021-03-31 |
| Wendy S Levine Md | 320 Pine Creek Ave, Fairfield, CT 06824-6390 | Physician/surgeon | 2020-04-01 ~ 2021-03-31 |
| Wendy Drew Ellis | P. O. Box 660070, Birmingham, AL 35266 | Physician/surgeon | 2019-09-01 ~ 2020-08-31 |
| Wendy A Kissinger | 1027 Partridge Dr, Wadsworth, OH 44281-8801 | Physician/surgeon | 2020-01-01 ~ 2020-12-31 |
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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).