ERIC W BLACK (Credential# 1320166) 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.
ERIC W BLACK is licensed with the Department of Consumer Protection of Connecticut. The credential number is #CSP.0061739. 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 365 Mather St Apt 197, Hamden, CT 06514-3151. The current status is active.
| Licensee Name | ERIC W BLACK |
| Credential ID | 1320166 |
| Credential Number | CSP.0061739 |
| Credential Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| Business Address |
365 Mather St Apt 197 Hamden CT 06514-3151 |
| Business Type | INDIVIDUAL |
| Status | ACTIVE - CURRENT |
| Active | 1 |
| Issue Date | 2015-11-10 |
| Effective Date | 2019-03-01 |
| Expiration Date | 2021-02-28 |
| Refresh Date | 2019-01-10 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 1315769 | 23.003462 | Physician Assistant | 2015-10-19 | 2020-02-01 - 2021-01-31 | ACTIVE |
| Street Address | 365 MATHER ST APT 197 |
| City | HAMDEN |
| State | CT |
| Zip Code | 06514-3151 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Erika Henley | 175 Hightop Circle West, Hamden, CT 06514 | Master's Level Social Worker | 2020-06-01 ~ 2021-05-31 |
| Yunmi Lee | 144 Hill St, Hamden, CT 06514 | Combination Nail Technician, Esthetician Or Eyelash Technici | 2020-06-26 ~ 2022-05-31 |
| Rosa M Gordillo | 155 Gorham Ave, Hamden, CT 06514 | Combination Nail Technician, Esthetician Or Eyelash Technici | ~ |
| Linda C Disbrow | 61 Sherman Lane, Hamden, CT 06514 | Registered Nurse | 2020-09-01 ~ 2021-08-31 |
| Kimberly Marie Fernandes | 660 Mix Ave #1h, Hamden, CT 06514 | Radiographer | 2020-07-01 ~ 2021-06-30 |
| Marie Junie Cyril | 175 Oberlin Road, Hamden, CT 06514 | Registered Nurse | 2020-09-01 ~ 2021-08-31 |
| Erica Weiss | 4 Partridge Crossing, Hamden, CT 06514 | Physician/surgeon | 2020-07-01 ~ 2021-06-30 |
| Kimberly S Traverso | 50 Building Brook Road, Hamden, CT 06514 | Professional Counselor | 2020-08-01 ~ 2021-07-31 |
| Kevin A Guess | 3rd Street, Hamden, CT 06514 | Public Weigher | 2020-06-12 ~ 2021-06-30 |
| Marilyn Pavelus | 389 Gilbert Ave, Hamden, CT 06514 | Registered Nurse | 2020-07-01 ~ 2021-06-30 |
| Find all Licenses in zip 06514 | |||
| City | HAMDEN |
| Zip Code | 06514 |
| License Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| License Type + County | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER + HAMDEN |
| 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 R Scott | 650 Mix Ave Apt 5a, Hamden, CT 06514 | Controlled Substance Registration for Practitioner | 2008-03-01 ~ 2009-02-28 |
| Eric Fan Md | 200 Orchard St Ste 303, New Haven, CT 06511 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Eric J Balaguer Md | 31 River Rd Ste 100, Cos Cob, CT 06807-2152 | Controlled Substance Registration for Practitioner | 2011-03-01 ~ 2013-02-28 |
| Eric Lao | 8 Sea Island, Glastonbury, CT 06033-1476 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Eric Lin | 300 George St Ste 901, New Haven, CT 06511-6662 | 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 |
| Eric Levy Md | 15 Valley Dr, Greenwich, CT 06831-5205 | Controlled Substance Registration for Practitioner | 2013-03-01 ~ 2015-02-28 |
| Eric P Launer | 55 Fox Rd Unit 926, Waltham, MA 02451-0270 | Controlled Substance Registration for Practitioner | 2014-12-12 ~ 2017-02-28 |
Please comment or provide details below to improve the information on ERIC W 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).