RY BLOOMDAHL (Credential# 2037282) is licensed (Resident Physician) with Connecticut Department of Consumer Protection. The license effective date is July 1, 2020. The license expiration date date is June 30, 2021. The license status is ACTIVE.
RY BLOOMDAHL is licensed with the Department of Consumer Protection of Connecticut. The credential number is #1.065285-RES. The credential type is resident physician. The effective date is July 1, 2020. The expiration date is June 30, 2021. The business address is 56 Franklin St, Waterbury, CT 06706-1253. The current status is active.
| Licensee Name | RY BLOOMDAHL |
| Credential ID | 2037282 |
| Credential Number | 1.065285-RES |
| Credential Type | Resident Physician |
| Credential SubCategory | RES |
| Business Address |
56 Franklin St Waterbury CT 06706-1253 |
| Business Type | INDIVIDUAL |
| Status | ACTIVE - CURRENT |
| Active | 1 |
| Issue Date | 2020-07-01 |
| Effective Date | 2020-07-01 |
| Expiration Date | 2021-06-30 |
| Refresh Date | 2020-04-22 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 2060911 | CSP.0074702 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 2020-06-26 | 2020-06-26 - 2021-02-28 | APPROVED |
| Street Address | 56 FRANKLIN ST |
| City | WATERBURY |
| State | CT |
| Zip Code | 06706-1253 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Benjamin Dahlberg | 56 Franklin St, Waterbury, CT 06706-1253 | Resident Physician | 2020-07-01 ~ 2026-06-30 |
| Vikram Bhatt | 56 Franklin St, Waterbury, CT 06706-1253 | Resident Physician | 2019-07-01 ~ 2026-06-30 |
| Sue-ting Lim | 56 Franklin St, Waterbury, CT 06706-1253 | Resident Physician | 2019-07-01 ~ 2024-06-30 |
| Suraj J Panjwani | 56 Franklin St, Waterbury, CT 06706-1253 | Resident Physician | 2019-07-01 ~ 2024-06-30 |
| Samir Dengle | 56 Franklin St, Waterbury, CT 06706-1253 | Resident Physician | 2020-07-01 ~ 2023-06-30 |
| Diego A Accorsi | 56 Franklin St, Waterbury, CT 06706-1253 | Resident Physician | 2019-07-01 ~ 2023-06-30 |
| Santosh Swaminathan | 56 Franklin St, Waterbury, CT 06706-1253 | Resident Physician | 2019-07-01 ~ 2023-06-30 |
| Saman Tariq | 56 Franklin St, Waterbury, CT 06706-1253 | Resident Physician | 2020-06-10 ~ 2023-06-20 |
| Michelle Yeung | 56 Franklin St, Waterbury, CT 06706-1253 | Resident Physician | 2020-06-15 ~ 2023-06-20 |
| Bhavya Vemuri | 56 Franklin St, Waterbury, CT 06706-1253 | Resident Physician | 2020-06-15 ~ 2023-06-20 |
| Find all Licenses in the same address | |||
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Kaitlyn Jennings | Saint Mary's Emergency Department, Waterbury, CT 06706-1253 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Vitas Healthcare Corporation Atlantic Inpatient Unit | 56 Franklin St Fl 4, Waterbury, CT 06706-1253 | Hospice | 2019-04-01 ~ 2021-03-31 |
| Julia Zefirova | Department of Medicine, Waterbury, CT 06706-1253 | Physician/surgeon | 2018-12-01 ~ 2019-11-30 |
| William A Fabricius | Department of Medicine, Waterbury, CT 06706-1253 | Controlled Substance Registration for Practitioner | 2013-03-01 ~ 2015-02-28 |
| Felipe V Orozco | Department of Medicine, Waterbury, CT 06706-1253 | Controlled Substance Registration for Practitioner | 2011-03-01 ~ 2013-02-28 |
| Evgeny Kirsanov | Department of Medicine, Waterbury, CT 06706-1253 | Controlled Substance Registration for Practitioner | 2011-03-01 ~ 2013-02-28 |
| Vinay Singh | Department of Medicine, Waterbury, CT 06706-1253 | Controlled Substance Registration for Practitioner | 2011-03-01 ~ 2013-02-28 |
| M A Sohail | Department of Medicine, Waterbury, CT 06706-1253 | Controlled Substance Registration for Practitioner | 2011-03-01 ~ 2013-02-28 |
| Mugen Liu | Department of Medicine, Waterbury, CT 06706-1253 | Controlled Substance Registration for Practitioner | 2009-03-05 ~ 2011-02-28 |
| Pingali C Mohan | Department of Medicine, Waterbury, CT 06706-1253 | Controlled Substance Registration for Practitioner | 2009-03-01 ~ 2011-02-28 |
| Find all Licenses in zip 06706-1253 | |||
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Yiajaira Morales | 424 Baldwin St., Waterbury, CT 06706 | Medication Administration Certification | 2020-05-01 ~ 2022-04-30 |
| Timiki M White | 921 Hamilton Avenue Unit 6, Waterbury, CT 06706 | Notary Public Appointment | 2020-06-01 ~ 2025-05-31 |
| Lymarie Torres Garcia | 107 Alpine Ave., Waterbury, CT 06706 | Licensed Practical Nurse | 2020-09-01 ~ 2021-08-31 |
| Ann M Iannantuoni | 456 Prospect Rd, Waterbury, CT 06706 | Registered Nurse | 2020-07-01 ~ 2021-06-30 |
| Brittany Morgan | 921 Hamilton Ave., Waterbury, CT 06706 | Medication Administration Certification | 2018-04-14 ~ 2020-04-13 |
| Chevelle Hinton | 35 Mountain Village Rd Unit 2, Waterbury, CT 06706 | Medication Administration Certification | 2020-05-19 ~ 2022-05-18 |
| Juan A Bano | 685 Summer St, Waterbury, CT 06706 | Asbestos Abatement Worker | ~ |
| Esther Campos Dasilva | 31 Benjamin St, Waterbury, CT 06706 | Emergency Medical Responder | ~ |
| Rebecca L Diblasi | 295 Edgewood Avenue, Waterbury, CT 06706 | Real Estate Salesperson | 2020-06-11 ~ 2021-05-31 |
| Rnz Services LLC | 76 Lounsbury Ave Apt 2, Waterbury, CT 06706 | Home Improvement Contractor | 2020-06-12 ~ 2020-11-30 |
| Find all Licenses in zip 06706 | |||
| City | WATERBURY |
| Zip Code | 06706 |
| License Type | Resident Physician |
| License Type + County | Resident Physician + WATERBURY |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Jin Woo Yoo | 44 Orange St Apt 317, New Haven, CT 06510 | Resident Physician | 2020-07-01 ~ 2021-06-30 |
| Victoria Parker | CT | Resident Physician | 2015-06-23 ~ 2021-06-30 |
| Gin Yi Lee | 24 Hospital Ave, Danbury, CT 06810-6099 | Resident Physician | 2019-06-20 ~ 2022-06-30 |
| Tao Zuo | 20 York St., New Haven, CT 06510-3220 | Resident Physician | 2016-07-25 ~ 2020-06-30 |
| Jennifer A Guy | 6 Early Dr Apt K, Watervliet, NY 12189-2517 | Resident Physician | ~ |
| Yan Zhu | 27 Brainerd Rd # B, Branford, CT 06405-6302 | Resident Physician | 2020-07-01 ~ 2021-06-30 |
| Jia Wei Tan | 267 Grant St, Bridgeport, CT 06610-2805 | Resident Physician | 2020-06-22 ~ 2023-06-30 |
| Mingwei Yu | 24 Hospital Ave, Danbury, CT 06810-6099 | Resident Physician | 2019-06-20 ~ 2022-06-30 |
| Eujin Yeo | 129 York St Apt 5b, New Haven, CT 06511-5605 | Resident Physician | 2020-06-08 ~ 2021-06-30 |
| Edward Lee | 20 York St, New Haven, CT 06510 | Resident Physician | 2020-06-24 ~ 2021-06-30 |
Please comment or provide details below to improve the information on RY BLOOMDAHL.
| 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).