LUCY E MODAHL (Credential# 561799) is licensed (Physician/surgeon) with Connecticut Department of Consumer Protection. The license effective date is July 2, 2019. The license expiration date date is April 30, 2020. The license status is ACTIVE.
LUCY E MODAHL is licensed with the Department of Consumer Protection of Connecticut. The credential number is #1.044217. The credential type is physician/surgeon. The effective date is July 2, 2019. The expiration date is April 30, 2020. The business address is 66 Bancroft Rd, Northampton, MA 01060-2111. The current status is active.
| Licensee Name | LUCY E MODAHL |
| Credential ID | 561799 |
| Credential Number | 1.044217 |
| Credential Type | Physician/Surgeon |
| Business Address |
66 Bancroft Rd Northampton MA 01060-2111 |
| Business Type | INDIVIDUAL |
| Status | ACTIVE - CURRENT |
| Active | 1 |
| Issue Date | 2006-04-03 |
| Effective Date | 2019-07-02 |
| Expiration Date | 2020-04-30 |
| Refresh Date | 2019-07-02 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 447712 | CSP.0040372 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 2006-08-23 | 2011-03-01 - 2013-02-28 | INACTIVE |
| Street Address | 66 BANCROFT RD |
| City | NORTHAMPTON |
| State | MA |
| Zip Code | 01060-2111 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Berkshire Natural LLC | 102 Bancroft Rd, Northampton, MA 01060-2111 | Vending Machine Operator | 2012-07-01 ~ 2013-06-30 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Martha H Lyon | 313 Elm St, Northampton, MA 01060 | Landscape Architect | 2020-08-01 ~ 2021-07-31 |
| Joanne N Corbin | 73 Barrett St., Northampton, MA 01060 | Licensed Clinical Social Worker | 2020-07-01 ~ 2021-06-30 |
| Anna C. Southam | 74 Bridge St #4, Northampton, MA 01060 | Physical Therapist | 2020-08-01 ~ 2021-07-31 |
| Christine Marie Grimaldi | 49 Pine Brook Curve, Northampton, MA 01060 | Occupational Therapist | 2020-05-21 ~ 2021-07-31 |
| Ali Haider | 51 Phillips Place, Northampton, MA 01060 | Physician/surgeon | 2020-06-01 ~ 2021-05-31 |
| Paul W Harrigan | 63 Center Street, Northampton, MA 01060 | Massage Therapist | 2020-06-01 ~ 2022-05-31 |
| Barbara A Maronn | 243 King Street, Ste 107, Northampton, MA 01060 | Tax Preparer/facilitator Permit | 2020-03-10 ~ 2022-03-31 |
| Carol Karney | 37 Fair Street, Northampton, MA 01060 | Real Estate Broker | 2020-04-01 ~ 2021-03-31 |
| Jason Doyon | 9 1/2 Market Street, Northampton, MA 01060 | Tax Preparer/facilitator Permit | 2020-02-12 ~ 2022-02-28 |
| Deevia Chandrakant Patel | 111 Prospect Street, Northampton, MA 01060 | Physician/surgeon | 2020-02-07 ~ 2020-10-31 |
| Find all Licenses in zip 01060 | |||
| City | NORTHAMPTON |
| Zip Code | 01060 |
| License Type | Physician/Surgeon |
| License Type + County | Physician/Surgeon + NORTHAMPTON |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Anu Bansal Md | 33 Lucy Way, Simsbury, CT 06070 | Physician/surgeon | 2020-06-01 ~ 2021-05-31 |
| Lucy M. Sun | 78 Marlborough Rd, Briarcliff Manor, NY 10510-2011 | Physician/surgeon | 2013-06-21 ~ 2013-11-30 |
| David M Ozimek | 8 Lucy Way, Simsbury, CT 06070 | Physician/surgeon | 2020-06-01 ~ 2021-05-31 |
| Lucy Shen-sye | 68 Lantern Drive, Stamford, CT 06905 | Physician/surgeon | 2019-12-01 ~ 2020-11-30 |
| Lucy Evelyn Wojcicki | 400 Columbus Ave, New Haven, CT 06519-1233 | Physician/surgeon | 2020-07-01 ~ 2021-06-30 |
| Lucy D. Flynn | 28 Lafayette Place, Greenwich, CT 06830 | Physician/surgeon | 2020-06-01 ~ 2021-05-31 |
| Melissa Lucy Larusso | 291 Independence Dr., Chestnut Hill, MA 02467 | Physician/surgeon | 2020-03-02 ~ 2021-03-31 |
| Dean A Rose | 4160 Lucy Long Drive, Harrisburg, PA 22801 | Physician/surgeon | 1995-11-09 ~ 1996-11-30 |
| Lucy Carriero Md | 99 East River Dr, 5th Fl, East Hartford, CT 06108 | Physician/surgeon | 2020-04-01 ~ 2021-03-31 |
| Lucy Kaiitlyn Faulkner | 8 Lucy Ln, Guilford, CT 06437-4701 | Professional Counselor Associate | 2020-02-19 ~ 2021-02-28 |
Please comment or provide details below to improve the information on LUCY E MODAHL.
| 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).