DANIEL E FORMAN (Credential# 1119751) is licensed (Speech and Language Pathologist) with Connecticut Department of Consumer Protection. The license effective date is November 1, 2019. The license expiration date date is October 31, 2020. The license status is ACTIVE.
DANIEL E FORMAN is licensed with the Department of Consumer Protection of Connecticut. The credential number is #18.004765. The credential type is speech and language pathologist. The effective date is November 1, 2019. The expiration date is October 31, 2020. The business address is 47 Richard Sweet Dr, Woodbridge, CT 06525-1128. The current status is active.
| Licensee Name | DANIEL E FORMAN |
| Credential ID | 1119751 |
| Credential Number | 18.004765 |
| Credential Type | Speech and Language Pathologist |
| Business Address |
47 Richard Sweet Dr Woodbridge CT 06525-1128 |
| Business Type | INDIVIDUAL |
| Status | ACTIVE - CURRENT |
| Active | 1 |
| Issue Date | 2013-12-09 |
| Effective Date | 2019-11-01 |
| Expiration Date | 2020-10-31 |
| Refresh Date | 2019-10-01 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 1122659 | 18-TEMP | Speech and Language Pathologist Temporary Permit | 2012-08-20 - 2013-06-21 | INACTIVE |
| Street Address | 47 RICHARD SWEET DR |
| City | WOODBRIDGE |
| State | CT |
| Zip Code | 06525-1128 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Sara Beth Steinberg Forman | 47 Richard Sweet Dr, Woodbridge, CT 06525-1128 | Behavior Analyst | 2019-08-01 ~ 2020-07-31 |
| Melvin B Laubstein | 47 Richard Sweet Dr, Woodbridge, CT 06525 | Physician/surgeon | 1994-05-18 ~ 1995-06-30 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Hyue Kyung Choi | 11 Rock Hill Road, Woodbridge, CT 06525 | Combination Nail Technician, Esthetician Or Eyelash Technici | ~ |
| Jewish Cemetery Association of Greater New Haven | 360 Amity Road, Woodbridge, CT 06525 | Public Charity | 2020-07-01 ~ 2021-06-30 |
| Nancy Bradstreet | 146 Northrop Rd., Woodbridge, CT 06525 | Licensed Clinical Social Worker | 2020-09-01 ~ 2021-08-31 |
| Robert I Tucker | 15 Research Drive, Woodbridge, CT 06525 | Architect | 2020-08-01 ~ 2021-07-31 |
| Amity Brick Oven Pizza Inc · Joseph R Sarno | 142 Amity Rd, New Haven, CT 06525 | Bakery | 2020-07-01 ~ 2021-06-30 |
| Linda A Starace-colabella | 895 Baldwin Rd, Woodbridge, CT 06525 | Physician/surgeon | 2020-08-01 ~ 2021-07-31 |
| Patricia A Kenyon · Leskow | 8 Maple Terrace, Woodbridge, CT 06525 | Registered Nurse | 2020-09-01 ~ 2021-08-31 |
| Marianne L Dexter | 37 Acorn Hill Rd, Woodbridge, CT 06525 | Registered Nurse | 2020-08-01 ~ 2021-07-31 |
| Debra G Wayne | 94 Maple Vale Drive, Woodbridge, CT 06525 | Psychologist | 2020-09-01 ~ 2021-08-31 |
| Timothy Michael Carney | 1119 Racebrook Road, Woodbridge, CT 06525 | Emergency Medical Technician | 2016-08-19 ~ 2020-03-31 |
| Find all Licenses in zip 06525 | |||
| City | WOODBRIDGE |
| Zip Code | 06525 |
| License Type | Speech and Language Pathologist |
| License Type + County | Speech and Language Pathologist + WOODBRIDGE |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Jo Ann Q Forman | 110 Griswold Dr, West Hartford, CT 06119 | Speech and Language Pathologist | 2020-08-01 ~ 2021-07-31 |
| Debra A Forman | 454 Burr Rd, Southbury, CT 06488-2788 | Speech and Language Pathologist | 2009-12-01 ~ 2010-04-30 |
| Daniel Landino | 49 Mcmahon Lane, North Branford, CT 06471 | Speech and Language Pathologist | 2019-12-01 ~ 2020-11-30 |
| Carissa D Hunter | Josephine Chin, Speech Pathologist, Greenwich, CT 06830 | Speech and Language Pathologist | 2006-10-17 ~ 2007-06-30 |
| Alida Engel | Center for Speech & Learning, New Haven, CT 06515 | Speech and Language Pathologist | 2020-05-01 ~ 2021-04-30 |
| Lois B Cook | Speech & Comm Prfls, Amawalk, NY 10501 | Speech and Language Pathologist | 2004-12-17 ~ 2005-12-31 |
| Miho Oya | 52 Butterfield Rd, Newtown, CT 06470-1016 | Speech and Language Pathologist | ~ |
| Samantha Greco | 4 Gem Dr, Ellington, CT 06029-3906 | Speech and Language Pathologist | ~ |
| Renee Cayer | 111 Elm St, Monroe, CT 06468-2217 | Speech and Language Pathologist | ~ |
| Ina G Carroll | 96 Day St, Granby, CT 06035-2900 | Speech and Language Pathologist | 1999-08-26 ~ 2000-05-31 |
Please comment or provide details below to improve the information on DANIEL E FORMAN.
| 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).