ANDREA C TAVLAN (Credential# 1229736) is licensed (Physician/surgeon) with Connecticut Department of Consumer Protection. The license effective date is July 1, 2016. The license expiration date date is June 30, 2017. The license status is INACTIVE.
ANDREA C TAVLAN is licensed with the Department of Consumer Protection of Connecticut. The credential number is #1.053394. The credential type is physician/surgeon. The effective date is July 1, 2016. The expiration date is June 30, 2017. The business address is 20 Westfield Ave, Ansonia, CT 06401. The current status is inactive.
| Licensee Name | ANDREA C TAVLAN |
| Credential ID | 1229736 |
| Credential Number | 1.053394 |
| Credential Type | Physician/Surgeon |
| Business Address |
20 Westfield Ave Ansonia CT 06401 |
| Business Type | INDIVIDUAL |
| Status | INACTIVE - LAPSED DUE TO NON-RENEWAL |
| Issue Date | 2014-08-01 |
| Effective Date | 2016-07-01 |
| Expiration Date | 2017-06-30 |
| Refresh Date | 2017-10-03 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 1223497 | CSP.0057200 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 2014-08-02 | 2015-03-01 - 2017-02-28 | INACTIVE |
| Street Address | 20 Westfield Ave |
| City | Ansonia |
| State | CT |
| Zip Code | 06401 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Robert L Lavallee Jr | 20 Westfield Ave, Ansonia, CT 06401 | Physician/surgeon | 2020-03-01 ~ 2021-02-28 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Rebecca Lynn Kunstadt | 7 Belleview Terrave, Ansonia, CT 06401 | Licensed Clinical Social Worker | 2020-07-01 ~ 2021-06-30 |
| Mann Inc | 505 Main St, Ansonia, CT 06401 | Operator of Weighing & Measuring Devices | 2020-08-01 ~ 2021-07-31 |
| Domino's Pizza · Nbs Pizza Inc Dba | 137 N Main St, Ansonia, CT 06401 | Bakery | 2020-07-01 ~ 2021-06-30 |
| Lisa Dilorenzo Sardo | 37 Kathy Lane, Ansonia, CT 06401 | Combination Nail Technician, Esthetician Or Eyelash Technici | ~ |
| Christi Lynn Crumb | 73 Woodbridge Ave, Ansonia, CT 06401 | Notary Public Appointment | 2020-04-09 ~ 2025-04-30 |
| Maureen E Witzmann | 68 Granite Terrace, Ansonia, CT 06401 | Registered Nurse | 2020-07-01 ~ 2021-06-30 |
| Anthony Wayne Md | 20 Westfield Avenue, Ansonia, CT 06401 | Physician/surgeon | 2020-09-01 ~ 2021-08-31 |
| Raymond P Ragaini | 30 Winter Street, Ansonia, CT 06401 | Notary Public Appointment | 2017-07-01 ~ 2022-06-30 |
| Margaret Rivera | 34 Church Street, Ansonia, CT 06401 | Notary Public Appointment | 2020-10-01 ~ 2025-09-30 |
| Nadine Frey · Tonucci | 7 North Coe Lane, Ansonia, CT 06401 | Hairdresser/cosmetician | 2020-07-01 ~ 2022-06-30 |
| Find all Licenses in zip 06401 | |||
| City | Ansonia |
| Zip Code | 06401 |
| License Type | Physician/Surgeon |
| License Type + County | Physician/Surgeon + Ansonia |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Andrea Vidali | 41 S 5th St Apt 11, Brooklyn, NY 11249-8417 | Physician/surgeon | ~ |
| Andrea C Lin | 9 N Gate Rd, Carmel, NY 10512-2213 | Physician/surgeon | 2010-09-09 ~ 2011-06-30 |
| Wen-ray T Hsu | 18 Andrea Lane, Scarsdale, NY 10583 | Physician/surgeon | 2007-12-19 ~ 2008-10-31 |
| Andrea E Andrews Md | Po Box 390695, Snellville, GA 30039 | Physician/surgeon | 2005-04-06 ~ 2006-04-30 |
| Andrea B Lese | 301 Central Ave Ne, Albuquerque, NM 87102-3885 | Physician/surgeon | 2015-10-01 ~ 2016-09-30 |
| Carl C D'andrea Md | 10 Pilgrim's Way, Gaylordsville, CT 06755 | Physician/surgeon | 2020-04-01 ~ 2021-03-31 |
| Andrea J Shaer | 118 Mattahasset Dr, Meriden, CT 06450 | Physician/surgeon | ~ 1996-10-31 |
| Andrea G Asnes | 324 Yale Ave, New Haven, CT 06515-2233 | Physician/surgeon | 2019-10-01 ~ 2020-09-30 |
| Andrea L Lundell | 105 Liberty Ln, Rockwall, TX 75032-8462 | Physician/surgeon | 2017-06-01 ~ 2018-05-31 |
| Andrea J Rock | 30 Lyon St # 3, New Haven, CT 06511-4926 | Physician/surgeon | 2012-06-01 ~ 2013-05-31 |
Please comment or provide details below to improve the information on ANDREA C TAVLAN.
| 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).