ABA A BLACK (Credential# 1171428) is licensed (Controlled Substance Registration for Practitioner) with Connecticut Department of Consumer Protection. The license effective date is March 1, 2019. The license expiration date date is February 28, 2021. The license status is ACTIVE.
ABA A BLACK is licensed with the Department of Consumer Protection of Connecticut. The credential number is #CSP.0055177. The credential type is controlled substance registration for practitioner. The effective date is March 1, 2019. The expiration date is February 28, 2021. The business address is 1450 Chapel Street, New Haven, CT 06511. The current status is active.
| Licensee Name | ABA A BLACK |
| Credential ID | 1171428 |
| Credential Number | CSP.0055177 |
| Credential Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| Business Address |
1450 Chapel Street New Haven CT 06511 |
| Business Type | INDIVIDUAL |
| Status | ACTIVE - CURRENT |
| Active | 1 |
| Issue Date | 2013-07-01 |
| Effective Date | 2019-03-01 |
| Expiration Date | 2021-02-28 |
| Refresh Date | 2019-05-17 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 1328280 | 1.055116 | Physician/Surgeon | 2016-04-01 | 2020-02-01 - 2021-01-31 | ACTIVE |
| Street Address | 1450 CHAPEL STREET |
| City | NEW HAVEN |
| State | CT |
| Zip Code | 06511 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Ha S Shin | 1450 Chapel Street, New Haven, CT 06511 | Pharmacist | 2020-02-01 ~ 2022-01-31 |
| Ebony Dix | 1450 Chapel Street, New Haven, CT 06511-6662 | Physician/surgeon | 2020-07-01 ~ 2021-06-30 |
| Sauda E Bholat | 1450 Chapel Street, New Haven, CT 06511 | Physician/surgeon | 2020-07-01 ~ 2021-06-30 |
| Anthony Earl Hammond | 1450 Chapel Street, New Haven, CT 06511 | Physician/surgeon | 2020-06-01 ~ 2021-05-31 |
| Yung Ah Lee | 1450 Chapel Street, New Haven, CT 06511 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Yihan Yang | 1450 Chapel Street, New Haven, CT 06511 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Lynda N Cook | 1450 Chapel Street, New Haven, CT 06511 | Registered Nurse | 2019-12-01 ~ 2020-11-30 |
| Kristen M Moyer | 1450 Chapel Street, New Haven, CT 06511 | Controlled Substance Registration for Practitioner | 2017-03-01 ~ 2019-02-28 |
| Esteban Verduzco | 1450 Chapel Street, New Haven, CT 06511 | Controlled Substance Registration for Practitioner | 2015-03-01 ~ 2017-02-28 |
| Ann B Sahakian Md | 1450 Chapel Street, New Haven, CT 06510 | Controlled Substance Registration for Practitioner | 2013-03-01 ~ 2015-02-28 |
| Find all Licenses in the same address | |||
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Montessori School On Edgewood Inc. | 230 Edgewood Avenue, New Haven, CT 06511 | Public Charity | 2019-06-01 ~ 2020-05-31 |
| Therese Parks · Visel Drug Store | 264 Munson St, New Haven, CT 06511 | Registered Nurse | 2020-07-01 ~ 2021-06-30 |
| Dazjia Monet Green | 115 Edgewood Ave Apt 64, New Haven, CT 06511 | Registered Nurse | 2020-06-27 ~ 2021-05-31 |
| Carol Yam | 343 Humphrey St, New Haven, CT 06511 | Registered Nurse | ~ |
| Marwan S Haddad | 38 Lincoln Street, New Haven, CT 06511 | Physician/surgeon | 2020-07-01 ~ 2021-06-30 |
| Mary Lou Gaeta Md | 558 Chapel Street, New Haven, CT 06511 | Physician/surgeon | 2020-07-01 ~ 2021-06-30 |
| Cary M Tucker | 64 Bishop St, New Haven, CT 06511 | Architect | 2020-08-01 ~ 2021-07-31 |
| Frank J Pannenborg | 505 Ellsworth Ave, New Haven, CT 06511 | Architect | 2020-08-01 ~ 2021-07-31 |
| Crystal E Gooding | 26 Woodland Street, New Haven, CT 06511 | Notary Public Appointment | 2020-07-01 ~ 2025-06-30 |
| Kieran Jones | 260 Crown St Unit 1f, New Haven, CT 06511 | Registered Nurse | ~ |
| Find all Licenses in zip 06511 | |||
| City | NEW HAVEN |
| Zip Code | 06511 |
| License Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| License Type + County | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER + NEW HAVEN |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| William Harless | 100 Black Rock Lighthouse Road, Black Rock, NS B1X 2A3 | Controlled Substance Registration for Practitioner | 2019-05-07 ~ 2021-02-28 |
| Eric W Black | 365 Mather St Apt 197, Hamden, CT 06514-3151 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Jonathan D Black | 120 Knollwood Dr, New Haven, CT 06515-2459 | Controlled Substance Registration for Practitioner | 2017-03-01 ~ 2019-02-28 |
| Eleanore K Black | 38 Volunteer Ln Apt 4, Greenwich, CT 06830-5414 | Controlled Substance Registration for Practitioner | 2020-06-04 ~ 2021-02-28 |
| David L Black | 31 Old Nursery Drive, Wilton, CT 06897 | Controlled Substance Registration for Practitioner | 2013-06-17 ~ 2015-02-28 |
| Kelley L Etheridge | 88 Black Walnut Dr, Durham, CT 06422-1400 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Deborah Black | 2127 Talmage Dr, Leland, NC 28451-9340 | Controlled Substance Registration for Practitioner | 2017-03-01 ~ 2019-02-28 |
| Joshua S Black | 109 Church St Unit 609, New Haven, CT 06510-3012 | Controlled Substance Registration for Practitioner | 2009-10-07 ~ 2011-02-28 |
| James C Black Md | 68 S Main St, West Hartford, CT 06107-2445 | Controlled Substance Registration for Practitioner | 2011-03-10 ~ 2013-02-28 |
| Thomas C Black | 61 Grouse Lane, Woodbridge, CT 06525 | Controlled Substance Registration for Practitioner | 2017-03-01 ~ 2019-02-28 |
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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).