JILLIAN L FORTIER (Credential# 1487272) is licensed (Physician/surgeon) with Connecticut Department of Consumer Protection. The license effective date is May 1, 2020. The license expiration date date is April 30, 2021. The license status is ACTIVE.
JILLIAN L FORTIER is licensed with the Department of Consumer Protection of Connecticut. The credential number is #1.060797. The credential type is physician/surgeon. The effective date is May 1, 2020. The expiration date is April 30, 2021. The business address is Uconn Health Center, Department of Surgery, Farmington, CT 06030-0001. The current status is active.
| Licensee Name | JILLIAN L FORTIER |
| Credential ID | 1487272 |
| Credential Number | 1.060797 |
| Credential Type | Physician/Surgeon |
| Business Address |
Uconn Health Center, Department of Surgery Farmington CT 06030-0001 |
| Business Type | INDIVIDUAL |
| Status | ACTIVE - CURRENT |
| Active | 1 |
| Issue Date | 2018-05-08 |
| Effective Date | 2020-05-01 |
| Expiration Date | 2021-04-30 |
| Refresh Date | 2020-04-27 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 1512306 | CSP.0067982 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 2018-05-09 | 2019-03-01 - 2021-02-28 | ACTIVE |
| Street Address | UCONN HEALTH CENTER, DEPARTMENT OF SURGERY |
| City | FARMINGTON |
| State | CT |
| Zip Code | 06030-0001 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Wendy A Miller | Mc1921 Farmington Ave # 263, Farmington, CT 06030-0001 | Physician/surgeon | 2020-06-01 ~ 2021-05-31 |
| Jason J Ziegler | 2 Courthouse Square, Farmington, CT 06030-0001 | Real Estate Salesperson | 2020-06-01 ~ 2021-05-31 |
| Bryden T Considine | L2104 of Medicine Rm, Farmington, CT 06030-0001 | Resident Physician | 2017-07-03 ~ 2021-06-30 |
| Dillon Paulo | 4260 Cordoba Ct, Farmington, CT 06030-0001 | Resident Physician | 2020-07-01 ~ 2024-06-30 |
| Erica Shen Nofziger | 263 Farmington Ave, Farmington, CT 06030-0001 | Resident Physician | 2020-07-01 ~ 2027-06-30 |
| Omar Ibrahim | 263 Farmington Ave # Mc-1321, Farmington, CT 06030-0001 | Physician/surgeon | 2020-06-01 ~ 2021-05-31 |
| Douglas Zelisko | 263 Farmington Ave Dept Of, Farmington, CT 06030-0001 | Physician/surgeon | 2020-04-23 ~ 2021-01-31 |
| Ruchir D Trivedi | 263 Farmington Ave # Mc-1405, Farmington, CT 06030-0001 | Physician/surgeon | 2020-06-01 ~ 2021-05-31 |
| Rawan J.j. Sarsour | 263 Farmington Ave # Mc3905, Farmington, CT 06030-0001 | Provisional Faculty Dentist | 2020-04-21 ~ 2021-04-30 |
| Angela Hart | General Medicine- Outpatient Pavilion, Farmington, CT 06030-0001 | Physician/surgeon | 2020-05-01 ~ 2021-04-30 |
| Find all Licenses in zip 06030-0001 | |||
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Eric Anthony Brueckner | 263 Farmington Ave., Farmington, CT 06030 | Physician/surgeon | 2020-08-01 ~ 2021-07-31 |
| Derrick B Bremang | Residency Program, Farmington, CT 06030 | Physician/surgeon | 2020-06-01 ~ 2021-06-30 |
| David M Shafer | Uconn Health Center, Farmington, CT 06030 | Dentist | 2020-07-01 ~ 2021-06-30 |
| Michael J Murphy | Dept of Dermatology, Farmington, CT 06030 | Physician/surgeon | 2020-09-01 ~ 2021-08-31 |
| Richard F Kaplan | Univ. of Ct., Farmington, CT 06030 | Psychologist | 2020-06-01 ~ 2021-05-31 |
| Nicholas George Vitale | 22 Woods Drive, Norwich, CT 06030 | Casino Class I Employee | 2019-12-03 ~ 2020-10-31 |
| Bruce E Gould | Univ of Conn Health Center, Farmington, CT 06030 | Physician/surgeon | 2020-04-01 ~ 2021-03-31 |
| Vinayak M Sathe | Uconn Health Center,263 Farmington Ave, Farmington, CT 06030 | Physician/surgeon | 2020-06-01 ~ 2021-05-31 |
| Shobhana Pathani | Department of Medicine, 263 Farmington Ave, CT 06030 | Physician/surgeon | 2020-06-01 ~ 2021-05-31 |
| Patricia L Almeida | John Dempsey Hospital, Farmington, CT 06030 | Registered Nurse | 2020-04-01 ~ 2021-03-31 |
| Find all Licenses in zip 06030 | |||
| City | FARMINGTON |
| Zip Code | 06030 |
| License Type | Physician/Surgeon |
| License Type + County | Physician/Surgeon + FARMINGTON |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Alexander J Fortier Md | 505 Willard Ave Ste 2b, Newington, CT 06111 | Physician/surgeon | 2016-07-01 ~ 2017-06-30 |
| Lawrence J Fortier | Cosmetic Laser and Skin Care Center, Wethersfield, CT 06109 | Physician/surgeon | 2020-04-01 ~ 2021-03-31 |
| Jillian Smith Md | 7 Isleib Rd, Marlborough, CT 06447 | Physician/surgeon | 2020-06-01 ~ 2021-05-31 |
| Jillian Kateri Warejko | 333 Cedar St, New Haven, CT 06520 | Physician/surgeon | 2020-07-01 ~ 2021-06-30 |
| Kenneth S Robson Md | 36 Jillian Cir, West Hartford, CT 06107-3159 | Physician/surgeon | 2019-11-01 ~ 2020-10-31 |
| Patrick J Fortier Inc · P Fortier & Sons Inc | 66 Locust St, West Haven, CT 06516 | Home Improvement Contractor | 2019-12-01 ~ 2020-11-30 |
| Richard Fortier · Fortier Exteriors | 739 Mt Vernon Rd, Southington, CT 06489 | Home Improvement Contractor | 1999-12-01 ~ 2000-11-30 |
| Thomas D Springer | 47 Jillian Circle, West Hartford, CT 06107 | Physician/surgeon | 2012-04-01 ~ 2013-03-31 |
| J David Schnatz Md | 14 Jillian Circle, West Hartford, CT 06107-3158 | Physician/surgeon | 2005-02-28 ~ 2006-04-30 |
| Daniel J Fortier · Fortier's Home Improvement | 11 Academy St, Plainfield, CT 06374 | Home Improvement Contractor | 2015-12-01 ~ 2016-11-30 |
Please comment or provide details below to improve the information on JILLIAN L FORTIER.
| 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).