AMANDA M MEULENBERG MD
Physician/surgeon


Address: 12 Avery Pl, Westport, CT 06880-3223

AMANDA M MEULENBERG MD (Credential# 565065) is licensed (Physician/surgeon) with Connecticut Department of Consumer Protection. The license effective date is January 1, 2019. The license expiration date date is December 31, 2019. The license status is INACTIVE.

Business Overview

AMANDA M MEULENBERG MD is licensed with the Department of Consumer Protection of Connecticut. The credential number is #1.047483. The credential type is physician/surgeon. The effective date is January 1, 2019. The expiration date is December 31, 2019. The business address is 12 Avery Pl, Westport, CT 06880-3223. The current status is inactive.

Basic Information

Licensee Name AMANDA M MEULENBERG MD
Credential ID 565065
Credential Number 1.047483
Credential Type Physician/Surgeon
Business Address 12 Avery Pl
Westport
CT 06880-3223
Business Type INDIVIDUAL
Status INACTIVE - LAPSED DUE TO NON-RENEWAL; PRIOR DISCIPLINE
Issue Date 2009-03-24
Effective Date 2019-01-01
Expiration Date 2019-12-31
Refresh Date 2020-06-08

Other licenses

ID Credential Code Credential Type Issue Term Status
529750 CSP.0045354 CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER 2009-04-09 2017-03-01 - 2019-02-28 LAPSED

Office Location

Street Address 12 AVERY PL
City WESTPORT
State CT
Zip Code 06880-3223

Licenses in the same location

Licensee Name Office Address Credential Effective / Expiration
Elizabeth Nadal 12 Avery Pl, Westport, CT 06880 Physician/surgeon 2020-04-01 ~ 2021-03-31
Nikko Dunlevy 12 Avery Pl, Westport, CT 06880-3223 Physician/surgeon 2020-04-01 ~ 2021-03-31
Marjorie Szeto Md 12 Avery Pl, Westport, CT 06880-3223 Controlled Substance Registration for Practitioner 2019-03-01 ~ 2021-02-28

Licenses in the same zip code

Licensee Name Office Address Credential Effective / Expiration
Toni L Bucker 4 Wild Rose Rd, Westport, CT 06880 Registered Nurse 2020-07-01 ~ 2021-06-30
Jee Hyun Kim 1 Allen Lane, Westport, CT 06880 Combination Nail Technician, Esthetician Or Eyelash Technici 2020-06-26 ~ 2021-07-31
Donna Vaccarella 15 Keyser Rd, Westport, CT 06880 Hairdresser/cosmetician 2020-09-01 ~ 2022-08-31
Sandra Gibson 12 Bayberry Ln, Westport, CT 06880 Registered Nurse 2020-08-01 ~ 2021-07-31
Adil Salam Md 44 Crawford Rd, Westport, CT 06880 Physician/surgeon 2020-07-01 ~ 2021-06-30
Joanne C Sosnoski 24 Hawatha Lane, Westport, CT 06880 Dental Hygienist 2020-08-01 ~ 2021-07-31
Rachel Lynn 495 Post Rd East, Westport, CT 06880 Eyelash Technician ~
Beginnings: An Infant/toddler Program 71 Hillandale Road, Westport, CT 06880 Group Child Care Home 2018-01-01 ~ 2021-12-31
Shelley S Ross 28 Old Hill Farms Rd, Westport, CT 06880 Dietitian/nutritionist 2020-08-01 ~ 2021-07-31
Robert W Van Summern 279 Wilton Rd, Westport, CT 06880 Architect 2020-08-01 ~ 2021-07-31
Find all Licenses in zip 06880

Competitor

Search similar business entities

City WESTPORT
Zip Code 06880
License Type Physician/Surgeon
License Type + County Physician/Surgeon + WESTPORT

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Amanda Medoro 54 Republic Dr Apt 111, Bloomfield, CT 06002-5444 Physician/surgeon 2016-05-01 ~ 2017-04-30
Amanda L Conti Md 9 Piezzo Dr, Westerly, RI 02891 Physician/surgeon 2020-04-01 ~ 2021-03-31
Amanda M. Hedges 852 Us Highway 1, Edison, NJ 08817 Physician/surgeon 2019-07-01 ~ 2020-06-30
Amanda L. Wilson 46 Sovereign Way, Florence, MA 01062-9615 Physician/surgeon 2016-11-01 ~ 2017-10-31
Amanda Stein Carmel 437 Melbourne Ave, Mamaroneck, NY 10543-2730 Physician/surgeon ~
Amanda J Russell-kleiner 41 Bronson Mtn, Roxbury, CT 06783-2126 Physician/surgeon 2019-11-01 ~ 2020-10-31
Amanda B Dill 24 Hospital Avenue, Danbury, CT 06810 Physician/surgeon 2005-06-13 ~ 2006-07-31

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Dataset Information

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).

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