TRACY L LAWRENCE BLACK (Credential# 1251110) is licensed (Physician/surgeon) with Connecticut Department of Consumer Protection. The license effective date is September 1, 2020. The license expiration date date is August 31, 2021. The license status is ACTIVE.
TRACY L LAWRENCE BLACK is licensed with the Department of Consumer Protection of Connecticut. The credential number is #1.053808. The credential type is physician/surgeon. The effective date is September 1, 2020. The expiration date is August 31, 2021. The business address is 53 Stonewall Cir, West Harrison, NY 10604-1126. The current status is active.
| Licensee Name | TRACY L LAWRENCE BLACK |
| Credential ID | 1251110 |
| Credential Number | 1.053808 |
| Credential Type | Physician/Surgeon |
| Business Address |
53 Stonewall Cir West Harrison NY 10604-1126 |
| Business Type | INDIVIDUAL |
| Status | ACTIVE - CURRENT |
| Active | 1 |
| Issue Date | 2015-01-30 |
| Effective Date | 2020-09-01 |
| Expiration Date | 2021-08-31 |
| Refresh Date | 2020-06-08 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 1371162 | CSP.0063751 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 2016-08-09 | 2019-03-01 - 2021-02-28 | ACTIVE |
| Street Address | 53 STONEWALL CIR |
| City | WEST HARRISON |
| State | NY |
| Zip Code | 10604-1126 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Stefania Maria Perez | 121 Macri Ave, West Harrison, NY 10604 | Registered Nurse | ~ |
| Danielle Piacente | 56 Underhill Avenue, West Harrison, NY 10604 | Registered Nurse | 2020-07-01 ~ 2021-06-30 |
| Kimberly Papachristou | 1 Golden Pond Road, West Harrison, NY 10604 | Real Estate Salesperson | 2020-06-01 ~ 2021-05-31 |
| Naixi Li | 83 Park Lane, West Harrison, NY 10604 | Physician/surgeon | 2020-09-01 ~ 2021-08-31 |
| Lee C Toterhi | 160 Gainsborg Ave E, West Harrison, NY 10604 | Registered Nurse | 2020-07-01 ~ 2021-06-30 |
| Emanuel I Wurm Do | Westchester Medical Group PC, White Plains, NY 10604 | Physician/surgeon | 2020-07-01 ~ 2021-06-30 |
| Edward G Swaby | 25 Chadwick Rd, White Plains, NY 10604 | Architect | 2018-08-01 ~ 2019-07-31 |
| Christina C Blanco | 210 Westchester Avenue, White Plains, NY 10604 | Physician/surgeon | 2020-06-01 ~ 2021-05-31 |
| Caleb K Charny Md | 210 Westchester Ave, White Plains, NY 10604 | Physician/surgeon | 2020-08-01 ~ 2021-07-31 |
| Paul C Moloney Jr · Paul C Moloney Inc | 12 High Ridge Road, West Harrison, NY 10604 | Swimming Pool Builder - In Ground | 2020-05-01 ~ 2021-04-30 |
| Find all Licenses in zip 10604 | |||
| City | WEST HARRISON |
| Zip Code | 10604 |
| License Type | Physician/Surgeon |
| License Type + County | Physician/Surgeon + WEST HARRISON |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Lawrence P Kirschenbaum Md | 305 Black Rock Tpke, Fairfield, CT 06825-5508 | Physician/surgeon | 2020-07-01 ~ 2021-06-30 |
| Tracy Mack | 540 Litchfield St, Torrington, CT 06790-6679 | Physician/surgeon | 2020-08-01 ~ 2021-07-31 |
| Bliss W. Clark | 3063 Remington Way, Tracy, CA 95377-6678 | Physician/surgeon | 2011-12-01 ~ 2012-12-31 |
| Tracy-ann M Clarke-leconte | 1 Jeanine Ct, Dix Hills, NY 11746 | Physician/surgeon | 2019-08-01 ~ 2020-07-31 |
| Tracy A Kritz | 1146 W 17th St, San Pedro, CA 90731-3834 | Physician/surgeon | 2017-03-01 ~ 2018-02-28 |
| Lee Tracy Silva | 1275 Summer St Ste 105, Stamford, CT 06905-5315 | Physician/surgeon | 2020-05-01 ~ 2021-04-30 |
| William Tracy Schmidt | 1281 E Main St, Stamford, CT 06902-3544 | Physician/surgeon | 2020-06-01 ~ 2021-05-31 |
| Edward Tracy Sall | 5471 Kearny Villa Rd, San Diego, CA 92123-1151 | Physician/surgeon | ~ |
| Tracy A Minichiello | 80-1 Cosey Beach Ave, East Haven, CT 06512 | Physician/surgeon | 1998-09-02 ~ 1999-09-30 |
| Jed E Black | 200 Evergreen Ave, Hamden, CT 06518 | Physician/surgeon | 1992-03-24 ~ 1993-02-28 |
Please comment or provide details below to improve the information on TRACY L LAWRENCE BLACK.
| 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).