RAPHAEL A CARANDANG MD (Credential# 883769) is licensed (Physician/surgeon) with Connecticut Department of Consumer Protection. The license effective date is October 1, 2019. The license expiration date date is September 30, 2020. The license status is ACTIVE.
RAPHAEL A CARANDANG MD is licensed with the Department of Consumer Protection of Connecticut. The credential number is #1.048305. The credential type is physician/surgeon. The effective date is October 1, 2019. The expiration date is September 30, 2020. The business address is 55 Lake Ave N, Worcester, MA 01655-0002. The current status is active.
| Licensee Name | RAPHAEL A CARANDANG MD |
| Credential ID | 883769 |
| Credential Number | 1.048305 |
| Credential Type | Physician/Surgeon |
| Business Address |
55 Lake Ave N Worcester MA 01655-0002 |
| Business Type | INDIVIDUAL |
| Status | ACTIVE - CURRENT |
| Active | 1 |
| Issue Date | 2009-12-14 |
| Effective Date | 2019-10-01 |
| Expiration Date | 2020-09-30 |
| Refresh Date | 2019-09-26 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 528861 | CSP.0045315 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 2009-12-16 | 2013-03-01 - 2015-02-28 | INACTIVE |
| Street Address | 55 LAKE AVE N |
| City | WORCESTER |
| State | MA |
| Zip Code | 01655-0002 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Nils Henninger | 55 Lake Ave N, Worcester, MA 01655-0002 | Physician/surgeon | 2020-06-01 ~ 2021-05-31 |
| Wiley R Hall | 55 Lake Ave N, Worcester, MA 01655 | Physician/surgeon | 2020-06-01 ~ 2021-05-31 |
| Susanne Muehlschlegel Md | 55 Lake Ave N, Worcester, MA 01655-0002 | Physician/surgeon | 2020-06-01 ~ 2021-05-31 |
| Adalia H. Jun-o'connell | 55 Lake Ave N, Worcester, MA 01655-0002 | Physician/surgeon | 2020-06-01 ~ 2021-05-31 |
| Leslie J Domalik | 55 Lake Ave N, Worcester, MA 01655-0002 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Daniel J Weber | 55 Lake Ave N, Worcester, MA 01655-0002 | Physician/surgeon | 2017-10-01 ~ 2018-09-30 |
| Shirin Haddady Md | 55 Lake Ave N, Worcester, MA 01655 | Physician/surgeon | 2014-07-01 ~ 2015-06-30 |
| Craig Smith Md | 55 Lake Ave N, Worcester, MA 01655 | Controlled Substance Registration for Practitioner | 2013-03-01 ~ 2015-02-28 |
| Mira Torres Md | 55 Lake Ave N, Worcester, MA 01655 | Controlled Substance Registration for Practitioner | 2011-03-01 ~ 2013-02-28 |
| Brian Mady Md | 55 Lake Ave N, Worcester, MA 01655 | Controlled Substance Registration for Practitioner | 2008-03-01 ~ 2009-02-28 |
| Find all Licenses in the same address | |||
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Umass Memorial Medical Center Specialty Pharmacy | 55 Lake Ave North Acc Building 1st Floor, Worcester, MA 01655-0002 | Nonresident Pharmacy | 2019-09-01 ~ 2020-08-31 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Carolina Ionete | 55 Lake Avenue, Worcester, MA 01655 | Physician/surgeon | 2020-07-01 ~ 2021-06-30 |
| Thomas J Fitzgerald | 55 Lake Ave, N, Worcester, MA 01655 | Physician/surgeon | 2020-06-01 ~ 2021-05-31 |
| Majaz Moonis Md | Umassmemorial Health Care, Neurology, 55 Lake Ave, Worcester, MA 01655 | Physician/surgeon | 2020-06-01 ~ 2021-05-31 |
| Ari Wilkenfeld | Neurology Department � 5th Floor, Worcester, MA 01655 | Physician/surgeon | ~ |
| Kate Daniello | 55 N Lake Ave, Worcester, MA 01655 | Physician/surgeon | 2020-04-01 ~ 2021-03-31 |
| Brian Silver | 55 Lake Avenue North, Worcester, MA 01655 | Physician/surgeon | 2020-01-01 ~ 2020-12-31 |
| Andrew Bouley | Umass Memorial, Department of Neurology, Worcester, MA 01655 | Physician/surgeon | 2019-04-01 ~ 2020-03-31 |
| Cheryl A Laflamme Aprn | 58 Bentwood Dr, Sturbridge, MA 01655 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Lawrence S Rosenthal Md | Umass Memorial Medical Center, Worcester, MA 01655 | Physician/surgeon | 2016-08-01 ~ 2017-07-31 |
| Daniel Z Fisher Md | 55 Lake Ave North, Worcester, MA 01655 | Controlled Substance Registration for Practitioner | 2013-03-01 ~ 2015-02-28 |
| Find all Licenses in zip 01655 | |||
| City | WORCESTER |
| Zip Code | 01655 |
| License Type | Physician/Surgeon |
| License Type + County | Physician/Surgeon + WORCESTER |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Raphael M Cooper | 12 Great Oak Ln, Unionville, CT 06085-1544 | Physician/surgeon | 2020-05-01 ~ 2021-04-30 |
| Ronan Ali Md | Hospital of St.raphael, New Haven, CT 06511 | Physician/surgeon | 2008-03-04 ~ 2009-04-30 |
| Raphael T Schein | 101 B Town Green, Wilton, CT 06897 | Physician/surgeon | 1995-01-04 ~ 1996-01-31 |
| Alan H Tralins | St. Raphael Hospital, New Haven, CT 06510 | Physician/surgeon | 1983-07-26 ~ 1984-02-28 |
| Raphael Zahler | 2630 Canterbury Rd, San Marino, CA 91108 | Physician/surgeon | 1997-05-12 ~ 1998-06-30 |
| Nana A Arthur Md | Hospital of St.raphael, New Haven, CT 06511 | Physician/surgeon | 2007-04-10 ~ 2008-05-31 |
| Raphael D Schwartz | 10 Shady Lane, Ridgefield, CT 06877 | Physician/surgeon | 2015-02-01 ~ 2016-01-31 |
| Stacie Perlman Md | Hospital of St.raphael, New Haven, CT 06511 | Physician/surgeon | 2007-02-23 ~ 2008-04-30 |
| Raphael J De Lima | 3640 Main Street, Springfield, MA 01107-1139 | Physician/surgeon | 2008-10-14 ~ 2009-10-31 |
| Jay H Reich Md | Hosp of St Raphael Dept of Emrg Med, New Haven, CT 06511 | Physician/surgeon | 2000-02-14 ~ 2001-04-30 |
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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).