GLEN D BLOMSTROM
Physician/surgeon


Address: 31 Smiths Point Road, Milford, CT 06460

GLEN D BLOMSTROM (Credential# 1134496) is licensed (Physician/surgeon) with Connecticut Department of Consumer Protection. The license effective date is April 1, 2020. The license expiration date date is March 31, 2021. The license status is ACTIVE.

Business Overview

GLEN D BLOMSTROM is licensed with the Department of Consumer Protection of Connecticut. The credential number is #1.051665. The credential type is physician/surgeon. The effective date is April 1, 2020. The expiration date is March 31, 2021. The business address is 31 Smiths Point Road, Milford, CT 06460. The current status is active.

Basic Information

Licensee Name GLEN D BLOMSTROM
Credential ID 1134496
Credential Number 1.051665
Credential Type Physician/Surgeon
Business Address 31 Smiths Point Road
Milford
CT 06460
Business Type INDIVIDUAL
Status ACTIVE - CURRENT
Active 1
Issue Date 2013-03-01
Effective Date 2020-04-01
Expiration Date 2021-03-31
Refresh Date 2020-01-13

Other licenses

ID Credential Code Credential Type Issue Term Status
895546 CSP.0046644 CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER 2010-09-23 2019-03-01 - 2021-02-28 ACTIVE
865702 70.931672 Emergency Medical Technician 1993-08-01 2004-10-19 - 2007-09-30 INACTIVE
878150 71.990055 Advanced Emergency Medical Technician 1999-05-01 - 2001-09-30 INACTIVE

Office Location

Street Address 31 Smiths Point Road
City Milford
State CT
Zip Code 06460

Licenses in the same zip code

Licensee Name Office Address Credential Effective / Expiration
Milford Council On Aging 9 Jepson Drive, Milford, CT 06460 Public Charity 2019-06-01 ~ 2020-05-31
James J Melanson 319 Welch's Point Road, Milford, CT 06460 Optician 2020-08-01 ~ 2021-07-31
Robert J Colum 61 Melba St, Milford, CT 06460 Professional Engineer 2020-06-16 ~ 2021-01-31
James E Phillips 88 Noble Ave, Milford, CT 06460 Physician/surgeon 2020-07-01 ~ 2021-06-30
Douglas H Gruber 33 Lincoln Ave, Milford, CT 06460 Licensed Alcohol and Drug Counselor 2020-06-01 ~ 2021-05-31
Christine D Rettig 1 Schooner Lane, Milford, CT 06460 Physical Therapist 2020-07-01 ~ 2021-06-30
Golden Dragon Inc 262 D Quarry Rd, Mildord, CT 06460 Food Warehouse ~
Kelli-ann Armstrong 50 Cherry Street, Milford, CT 06460 Optometrist 2020-07-01 ~ 2021-06-30
Mary C Cohen 9 Stevens Street, Milford, CT 06460 Notary Public Appointment 2020-07-01 ~ 2025-06-30
Nicole Wilson 26 Daggett Street, Milford, CT 06460 Hairdresser/cosmetician 2020-08-01 ~ 2022-07-31
Find all Licenses in zip 06460

Competitor

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City Milford
Zip Code 06460
License Type Physician/Surgeon
License Type + County Physician/Surgeon + Milford

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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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