BLERTA GREEN (Credential# 1497893) is licensed (Physician/surgeon) with Connecticut Department of Consumer Protection. The license effective date is August 1, 2020. The license expiration date date is July 31, 2021. The license status is ACTIVE.
BLERTA GREEN is licensed with the Department of Consumer Protection of Connecticut. The credential number is #1.061064. The credential type is physician/surgeon. The effective date is August 1, 2020. The expiration date is July 31, 2021. The business address is 353 Rimmon Road, Woodbridge, CT 06525. The current status is active.
| Licensee Name | BLERTA GREEN |
| Credential ID | 1497893 |
| Credential Number | 1.061064 |
| Credential Type | Physician/Surgeon |
| Business Address |
353 Rimmon Road Woodbridge CT 06525 |
| Business Type | INDIVIDUAL |
| Status | ACTIVE - CURRENT |
| Active | 1 |
| Issue Date | 2018-05-22 |
| Effective Date | 2020-08-01 |
| Expiration Date | 2021-07-31 |
| Refresh Date | 2020-05-04 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 1289496 | CSP.0060496 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 2015-06-05 | 2019-03-01 - 2021-02-28 | ACTIVE |
| 1490012 | 1.058647-RES | Resident Physician | 2018-07-01 | 2018-07-01 - 2018-08-16 | INACTIVE |
| Street Address | 353 Rimmon Road |
| City | Woodbridge |
| State | CT |
| Zip Code | 06525 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Hyue Kyung Choi | 11 Rock Hill Road, Woodbridge, CT 06525 | Combination Nail Technician, Esthetician Or Eyelash Technici | ~ |
| Jewish Cemetery Association of Greater New Haven | 360 Amity Road, Woodbridge, CT 06525 | Public Charity | 2020-07-01 ~ 2021-06-30 |
| Nancy Bradstreet | 146 Northrop Rd., Woodbridge, CT 06525 | Licensed Clinical Social Worker | 2020-09-01 ~ 2021-08-31 |
| Robert I Tucker | 15 Research Drive, Woodbridge, CT 06525 | Architect | 2020-08-01 ~ 2021-07-31 |
| Amity Brick Oven Pizza Inc · Joseph R Sarno | 142 Amity Rd, New Haven, CT 06525 | Bakery | 2020-07-01 ~ 2021-06-30 |
| Linda A Starace-colabella | 895 Baldwin Rd, Woodbridge, CT 06525 | Physician/surgeon | 2020-08-01 ~ 2021-07-31 |
| Patricia A Kenyon · Leskow | 8 Maple Terrace, Woodbridge, CT 06525 | Registered Nurse | 2020-09-01 ~ 2021-08-31 |
| Marianne L Dexter | 37 Acorn Hill Rd, Woodbridge, CT 06525 | Registered Nurse | 2020-08-01 ~ 2021-07-31 |
| Debra G Wayne | 94 Maple Vale Drive, Woodbridge, CT 06525 | Psychologist | 2020-09-01 ~ 2021-08-31 |
| Timothy Michael Carney | 1119 Racebrook Road, Woodbridge, CT 06525 | Emergency Medical Technician | 2016-08-19 ~ 2020-03-31 |
| Find all Licenses in zip 06525 | |||
| City | Woodbridge |
| Zip Code | 06525 |
| License Type | Physician/Surgeon |
| License Type + County | Physician/Surgeon + Woodbridge |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Yu-hui Lee | 7-11 Green St Apt 4a, Metuchen, NJ 08840-2411 | Physician/surgeon | 2020-04-01 ~ 2021-03-31 |
| Stephanie Green Md | 2 Fox Den Way, Woodbridge, CT 06525 | Physician/surgeon | 2020-05-01 ~ 2021-04-30 |
| Kang Lu | 72 Green St, Athol, MA 01331-2603 | Physician/surgeon | 2020-02-01 ~ 2021-01-31 |
| Gary B Green | P O Box 15538, Durham, NC 27704 | Physician/surgeon | 1981-01-01 ~ 1992-12-31 |
| Anita Nair | 12 Green St, Congers, NY 10920-2307 | Physician/surgeon | 2020-03-01 ~ 2021-02-28 |
| Barry J Kuttner Md | 140 Green Rd, Meriden, CT 06450 | Physician/surgeon | 2003-06-18 ~ 2004-08-31 |
| Elizabeth A O'brien | 9 Forest Green Rd, Rye, NH 03870-2047 | Physician/surgeon | 2012-11-01 ~ 2013-10-31 |
| Lewis Shapiro Md | 140 Green Rd, Meriden, CT 06450 | Physician/surgeon | 2002-06-27 ~ 2003-04-30 |
| Ronald S Green | 142 Deer Run, Burlington, CT 06013-1828 | Physician/surgeon | 2015-09-01 ~ 2016-08-31 |
| Anisha D Patel Md | 966 Green Cir, Orange, CT 06477-1736 | Physician/surgeon | 2020-04-01 ~ 2021-03-31 |
Please comment or provide details below to improve the information on BLERTA GREEN.
| 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).