JAY S TILLMAN MD (Credential# 240692) 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.
JAY S TILLMAN MD is licensed with the Department of Consumer Protection of Connecticut. The credential number is #CSP.0030036. 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 507 Hopmeadow Street, Simsbury, CT 06070. The current status is active.
| Licensee Name | JAY S TILLMAN MD |
| Credential ID | 240692 |
| Credential Number | CSP.0030036 |
| Credential Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| Business Address |
507 Hopmeadow Street Simsbury CT 06070 |
| Business Type | INDIVIDUAL |
| Status | ACTIVE - CURRENT |
| Active | 1 |
| Issue Date | 2000-09-15 |
| Effective Date | 2019-03-01 |
| Expiration Date | 2021-02-28 |
| Refresh Date | 2019-01-02 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 556267 | 1.038679 | Physician/Surgeon | 2000-05-26 | 2019-09-01 - 2020-08-31 | ACTIVE |
| Street Address | 507 HOPMEADOW STREET |
| City | SIMSBURY |
| State | CT |
| Zip Code | 06070 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Henry Withers | 571 Hopmeadow St, Simsbury, CT 06070 | Landscape Architect | 2020-08-01 ~ 2021-07-31 |
| Nancy W Flanagan | 9 Carver Circle, Simsbury, CT 06070 | Real Estate Salesperson | 2020-06-23 ~ 2021-05-31 |
| Catharina A Bates | 12 East View Dr., Simsbury, CT 06070 | Real Estate Salesperson | 2020-06-25 ~ 2021-05-31 |
| Faith E Preato | 25 Squadron Line Rd, Simsbury, CT 06070 | Registered Nurse | 2020-07-01 ~ 2021-06-30 |
| Diane Bragoni | 542 Hopmeadow Street, #128, Simsbury, CT 06070 | Architect | 2020-08-01 ~ 2021-07-31 |
| Virginia S Durst · Banks | 20 Woodcliff Drive, Simsbury, CT 06070 | Registered Nurse | 2020-05-01 ~ 2021-04-30 |
| Caitlin M Cornier | 18 Saxton Brook Drive, Simsbury, CT 06070 | Registered Nurse | 2020-07-01 ~ 2021-06-30 |
| Nancy L Alleva · Maule | 1079 Hopmeadow St, Simsbury, CT 06070 | Respiratory Care Practitioner | 2020-09-01 ~ 2021-08-31 |
| Stephen R Birghenti · Simsbury Inn | 397 Hopmeadow St, Simsbury, CT 06070 | Hotel Liquor (50000 Or More Population) | 2019-08-14 ~ 2020-12-13 |
| Deborah L Poniatowski · Blase | 35 Munnisunk Dr, Simsbury, CT 06070 | Registered Nurse | 2020-08-01 ~ 2021-07-31 |
| Find all Licenses in zip 06070 | |||
| City | SIMSBURY |
| Zip Code | 06070 |
| License Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| License Type + County | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER + SIMSBURY |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Elizabeth A Tillman | 30 Mountain Rd, Farmington, CT 06032-2341 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Abigail Paige Tillman | 57 Geneva Ave, West Hartford, CT 06107 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Guy Tillman · Tillman's Carpentry | 1765 Stratford Ave, Bridgeport, CT 06607 | Home Improvement Contractor | 2006-02-10 ~ 2006-11-30 |
| Pat Tillman Foundation | 222 Merchandise Mart Plz Ste 1212, Chicago, IL 60654-4342 | Public Charity | 2019-12-01 ~ 2020-11-30 |
| Mint Tillman · Tillman & Liz Contractor | 45 Allen Place #c8, Hartford, CT 06106 | Home Improvement Contractor | 2005-08-11 ~ 2005-11-30 |
| Steven Kassels Md · Community Substance Abuse Center | Comm. Physicians PC/125 North Elm Street, Westfield, MA 01085 | Controlled Substance Registration for Practitioner | 2018-06-15 ~ 2019-02-28 |
| Shu-i Lin | CT | Controlled Substance Registration for Practitioner | 2017-06-12 ~ 2019-02-28 |
| Qi Che Md | Bridgeport, CT 06610 | Controlled Substance Registration for Practitioner | 2006-03-01 ~ 2007-02-28 |
| Hae J Kim Pa | New Haven, CT 06511 | Controlled Substance Registration for Practitioner | 2008-03-31 ~ 2009-02-28 |
| Erin K Fee | CT | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
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| 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).