CAROLYN H REVERCOMB (Credential# 558774) is licensed (Physician/surgeon) with Connecticut Department of Consumer Protection. The license effective date is September 17, 2007. The license expiration date date is September 30, 2008. The license status is INACTIVE.
CAROLYN H REVERCOMB is licensed with the Department of Consumer Protection of Connecticut. The credential number is #1.041191. The credential type is physician/surgeon. The effective date is September 17, 2007. The expiration date is September 30, 2008. The business address is 4807 28th Street South, Arlington, 22206. The current status is inactive.
| Licensee Name | CAROLYN H REVERCOMB |
| Credential ID | 558774 |
| Credential Number | 1.041191 |
| Credential Type | Physician/Surgeon |
| Business Address |
4807 28th Street South Arlington 22206 |
| Business Type | INDIVIDUAL |
| Status | INACTIVE - LAPSED DUE TO NON-RENEWAL |
| Issue Date | 2003-03-04 |
| Effective Date | 2007-09-17 |
| Expiration Date | 2008-09-30 |
| Refresh Date | 2009-07-08 |
| Street Address | 4807 28th Street South |
| City | Arlington |
| Zip Code | 22206 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Sheryl L Cosme | 1543 28th St. South, Arlington, VA 22206 | Registered Nurse | 2020-06-01 ~ 2021-05-31 |
| Samantha Stanworth Streng | 4801 27th Rd S, Arlington, VA 22206 | Master's Level Social Worker | 2019-11-01 ~ 2020-10-31 |
| Jacqueline A Fitzpatrick | 2711 S Adams St, Arlington, VA 22206 | Occupational Therapist | 2019-08-01 ~ 2021-07-31 |
| Kishori Mahulikar | 4869 28th St South Apt 2a, Madison, CT 22206 | Master's Level Social Worker | 2015-10-01 ~ 2016-09-30 |
| Latha S Chirunomula | 3305 Kemper Road, Arlington, VA 22206 | Physician/surgeon | 2014-06-01 ~ 2015-05-31 |
| Tracelyn A Hairston | 2711 S. Adams St, Arlington, VA 22206 | Registered Nurse | 2013-09-01 ~ 2014-08-31 |
| Rebecca L Fitelson | 4539 A 28th Rd S, Arlington, VA 22206 | Registered Nurse | 2013-02-01 ~ 2014-01-31 |
| Jeffrey M Patrician | 3000 S. Randolph Street, Arlington, VA 22206 | Dentist | 2011-03-01 ~ 2012-02-29 |
| Voting Integrity Project | 4649 B 28th Road South, Arlington, VA 22206 | Public Charity | ~ |
| Gregory S Lukmire | 2700 S Quincy St=300, Arlington, VA 22206 | Architect | 2004-08-01 ~ 2005-07-31 |
| Find all Licenses in zip 22206 | |||
| City | Arlington |
| Zip Code | 22206 |
| License Type | Physician/Surgeon |
| License Type + County | Physician/Surgeon + Arlington |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Carolyn D Howard | P.o. Box 672, Ashway, RI 02804 | Physician/surgeon | 2003-08-11 ~ 2004-08-31 |
| Carolyn A Clark Md | 43 Enterprise Dr, Bristol, CT 06010-7457 | Physician/surgeon | 2020-08-01 ~ 2021-07-31 |
| Carolyn A Deshefy | 67 Old Mill Rd, Middletown, CT 06457 | Physician/surgeon | 2019-06-01 ~ 2020-05-31 |
| Carolyn Jones Md | 36 Clark Ln, Waterford, CT 06385 | Physician/surgeon | 2004-01-12 ~ 2005-02-28 |
| Carolyn M Sofka | 535 E 70th St, New York, NY 10021-4823 | Physician/surgeon | 2019-09-01 ~ 2020-08-31 |
| Carolyn E Thompson | 210 E 64th St Fl 4, New York, NY 10065-7471 | Physician/surgeon | 2015-08-04 ~ 2016-08-31 |
| Carolyn B Cirello | 1026 E. Kerr Ave, Urbana, IL 61801 | Physician/surgeon | 2004-07-01 ~ 2005-07-31 |
| Carolyn B Becker | 35 Haris Road, Brewster, NY 10509 | Physician/surgeon | 1996-02-16 ~ 1996-12-31 |
| Carolyn Ruth Blackman | 40 Arbor Way, East Greenwich, RI 02818 | Physician/surgeon | ~ |
| Carolyn Lafleur Md | 21 Millstone Ridge Rd, New Milford, CT 06776 | Physician/surgeon | 2010-08-01 ~ 2011-07-31 |
Please comment or provide details below to improve the information on CAROLYN H REVERCOMB.
| 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).