MARK BALLOW (Credential# 1039465) is licensed (Physician/surgeon) with Connecticut Department of Consumer Protection. The license effective date is October 28, 1970. The license expiration date date is September 30, 1988. The license status is INACTIVE.
MARK BALLOW is licensed with the Department of Consumer Protection of Connecticut. The credential number is #1.014661. The credential type is physician/surgeon. The effective date is October 28, 1970. The expiration date is September 30, 1988. The business address is 263 Farmington Ave, Farmington, CT 06032-1956. The current status is inactive.
| Licensee Name | MARK BALLOW |
| Credential ID | 1039465 |
| Credential Number | 1.014661 |
| Credential Type | Physician/Surgeon |
| Business Address |
263 Farmington Ave Farmington CT 06032-1956 |
| Business Type | INDIVIDUAL |
| Status | INACTIVE - LAPSED DUE TO NON-RENEWAL |
| Issue Date | 1970-10-28 |
| Effective Date | 1970-10-28 |
| Expiration Date | 1988-09-30 |
| Refresh Date | 2011-11-08 |
| Street Address | 263 FARMINGTON AVE |
| City | FARMINGTON |
| State | CT |
| Zip Code | 06032-1956 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Erica Shen Nofziger | 263 Farmington Ave, Farmington, CT 06030-0001 | Resident Physician | 2020-07-01 ~ 2027-06-30 |
| Matthew D Goranson | 263 Farmington Ave, Farmington, CT 06030-0001 | Resident Physician | 2020-07-01 ~ 2026-06-30 |
| Jacob Silver | 263 Farmington Ave, Farmington, CT 06030-0001 | Resident Physician | 2020-07-01 ~ 2025-06-30 |
| Nicholas Bellas | 263 Farmington Ave, Farmington, CT 06032-1956 | Resident Physician | 2020-07-01 ~ 2025-06-30 |
| Jennifer Hale | 263 Farmington Ave, Farmington, CT 06030-0001 | Resident Physician | 2020-07-01 ~ 2025-06-30 |
| Cory R Hewitt | 263 Farmington Ave, Farmington, CT 06030-0001 | Resident Physician | 2020-07-01 ~ 2025-06-30 |
| Sango Huwaa Mosia Asante | 263 Farmington Ave, Farmington, CT 06030-0001 | Resident Physician | 2020-07-01 ~ 2025-06-30 |
| Ryan Desrochers | 263 Farmington Ave, Farmington, CT 06030-0001 | Resident Physician | 2020-07-01 ~ 2025-06-30 |
| Kelsey D Greenhalgh | 263 Farmington Ave, Farmington, CT 06030-0001 | Resident Dentist | 2019-07-01 ~ 2025-06-30 |
| Derek J Tow | 263 Farmington Ave, Farmington, CT 06030-0001 | Resident Dentist | 2019-07-01 ~ 2025-06-30 |
| Find all Licenses in the same address | |||
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Joseph Palmisano | Uconn Health, Farmington, CT 06032-1956 | Physician/surgeon | 2020-04-01 ~ 2021-03-31 |
| Saqib Gowani | 263 Farmington Ave # Mc1235, Farmington, CT 06032-1956 | Physician/surgeon | 2019-01-01 ~ 2019-12-31 |
| Sandy J Poulin Pa | Uconn Health Center, Farmington, CT 06032-1956 | Controlled Substance Registration for Practitioner | 2009-03-01 ~ 2011-02-28 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Kyeongsuk Lee Lee | 11- A1 Lakeshore Dr, Farmington, CT 06032 | Nail Technician | ~ |
| Lynne M Ramer · Sobowicz | 13 Wentworth Park, Farmington, CT 06032 | Registered Nurse | 2020-08-01 ~ 2021-07-31 |
| Scott's Townline Mobil LLC | 435 Main St, Farmington, CT 06032 | Operator of Weighing & Measuring Devices | 2020-08-01 ~ 2021-07-31 |
| Glenna E Voytovich · Mietz | 47 Carriage Dr, Farmington, CT 06032 | Marital and Family Therapist | 2020-09-01 ~ 2021-08-31 |
| Munsons Chocolates | 463 Westfarms Mall, Farmington, CT 06032 | Operator of Weighing & Measuring Devices | 2020-08-01 ~ 2021-07-31 |
| Kimberly A. Caprio | Hartford Healthcare Medical Group, Farmington, CT 06032 | Physician/surgeon | 2020-07-01 ~ 2021-06-30 |
| Stephanie A. Fink | 22 Kent Lane, Farmington, CT 06032 | Registered Nurse | 2020-07-01 ~ 2021-06-30 |
| Farmington Donuts LLC · Dunkins Donuts | 348 Colt Hwy, Farmington, CT 06032 | Bakery | 2020-07-01 ~ 2021-06-30 |
| Angham Zakko | 2 Stratford Rd., Farmington, CT 06032 | Architect | 2020-08-01 ~ 2021-07-31 |
| Thomas N Taylor | 222 Main St # 264, Farmington, CT 06032 | Architect | 2020-08-01 ~ 2021-07-31 |
| Find all Licenses in zip 06032 | |||
| City | FARMINGTON |
| Zip Code | 06032 |
| License Type | Physician/Surgeon |
| License Type + County | Physician/Surgeon + FARMINGTON |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Mark M Silverstein | Mark Silverstein,md, Manchester, NJ 08759 | Physician/surgeon | 2020-02-01 ~ 2021-01-31 |
| Mark Davis | Po Box 222, Abingdon, MD 21009-0222 | Physician/surgeon | ~ |
| Mark A Sauer | Po Box 97, Pomfret, CT 06258 | Physician/surgeon | 1993-01-25 ~ 1994-01-31 |
| Mark Levin | 6 Gel Ct, Monsey, NY 10952-1956 | Physician/surgeon | 2020-06-01 ~ 2021-05-31 |
| Mark Dam | 15 Barringer Rd, Darien, CT 06820-2012 | Physician/surgeon | 2020-05-01 ~ 2021-04-30 |
| Ron Mark | 6 Annette Way, Jericho, NY 11753 | Physician/surgeon | 2019-09-01 ~ 2020-08-31 |
| Mark Snyder | 120 Terrace Ln, Hannibal, MO 63401-2768 | Physician/surgeon | ~ |
| Mark L Fox | 145 Huguenot St Ste 610, New Rochelle, NY 10801-5200 | Physician/surgeon | 2017-12-01 ~ 2018-11-30 |
| Mark J Harary Md | 31 River Rd Ste 100, Cos Cob, CT 06807-2152 | Physician/surgeon | 2012-06-01 ~ 2013-05-31 |
| Mark N Lobato | Ms # 11-tub, Hartford, CT 06134 | Physician/surgeon | 2015-12-01 ~ 2016-11-30 |
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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).