JACK B FRALINGER MD (Credential# 382438) is licensed (Controlled Substance Registration for Practitioner) with Connecticut Department of Consumer Protection. The license effective date is February 28, 2006. The license expiration date date is February 28, 2007. The license status is INACTIVE.
JACK B FRALINGER MD is licensed with the Department of Consumer Protection of Connecticut. The credential number is #CSP.0036417. The credential type is controlled substance registration for practitioner. The effective date is February 28, 2006. The expiration date is February 28, 2007. The business address is 1085 Rancho Road, Gallup, NM 87301. The current status is inactive.
| Licensee Name | JACK B FRALINGER MD |
| Credential ID | 382438 |
| Credential Number | CSP.0036417 |
| Credential Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| Business Address |
1085 Rancho Road Gallup NM 87301 |
| Business Type | INDIVIDUAL |
| Status | INACTIVE |
| Issue Date | 2004-10-21 |
| Effective Date | 2006-02-28 |
| Expiration Date | 2007-02-28 |
| Refresh Date | 2009-01-26 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 561717 | 1.044135 | Physician/Surgeon | 2006-03-07 | 2006-03-07 - 2006-12-31 | INACTIVE |
| Street Address | 1085 RANCHO ROAD |
| City | GALLUP |
| State | NM |
| Zip Code | 87301 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Lorraine Almo | 3702 Bonito Court, Gallup, NM 87301 | Registered Nurse | 2010-09-01 ~ 2011-08-31 |
| Betty S Thomas | 1705 Linda Dr, Gallup, NM 87301 | Registered Nurse | 1992-10-23 ~ 1993-10-31 |
| Patricia Acosta | 107 East Hill Ave, Gallup, NM 87301 | Respiratory Care Practitioner | ~ 1997-11-30 |
| Taiwo O Ehiman | 1716 Boulder Road, Gallup, NM 87301 | Registered Nurse | ~ 1999-08-31 |
| Melisa A Hemingway | 2003 West Highway 66, Gallup, NM 87301 | Occupational Therapist Assistant | 2005-07-12 ~ 2007-07-31 |
| Ankit Doshi | 1127 Boggio Dr, Gallup, NM 87301-4973 | Physician/surgeon | 2020-05-28 ~ 2020-09-30 |
| Catherine Bobea | 941 Cerrito Dr, Gallup, NM 87301-5421 | Pharmacist | 2020-02-01 ~ 2022-01-31 |
| Angeline R Requilman | 1710 Elm Cir Apt L83, Gallup, NM 87301-5873 | Registered Nurse | 2018-05-01 ~ 2019-04-30 |
| Colleen Marie Fischman | 211 S Puerco Dr Apt C, Gallup, NM 87301-6084 | Optometrist | 2020-04-19 ~ 2020-08-31 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| William W Bryant | Po Box 5010, Gallup, NM 87305 | Heating, Piping & Cooling Limited Journeyperson | ~ |
| City | GALLUP |
| Zip Code | 87301 |
| License Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| License Type + County | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER + GALLUP |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Jack Zazzaro, D.m.d. | 316 Main St S Ste D, Southbury, CT 06488-4238 | Controlled Substance Registration for Practitioner | 2016-03-14 ~ 2017-02-28 |
| Jack Finkelstein | 40 Gay St, Sharon, CT 06069 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Jack J Tse | 546 S Broad St, Meriden, CT 06450-6600 | Controlled Substance Registration for Practitioner | 2017-03-01 ~ 2019-02-28 |
| Jack Holden Md | Po Box 709, Orange, CT 06477 | Controlled Substance Registration for Practitioner | 2003-03-01 ~ 2004-02-28 |
| Jack D Berns | 123 York St, New Haven, CT 06511 | Controlled Substance Registration for Practitioner | 2015-03-01 ~ 2017-02-28 |
| Jack M Levine | 375 Orange St, New Haven, CT 06511-6406 | Controlled Substance Registration for Practitioner | 2019-02-28 ~ 2021-02-28 |
| Jack A Reynolds | 93 Randi Dr, Madison, CT 06443-2463 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Jack B Longley Md | 49 Woodstock Rd, Hamden, CT 06517 | Controlled Substance Registration for Practitioner | 2001-03-01 ~ 2002-02-28 |
| Jack Stark | 132 Main St, Danbury, CT 06810 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Jack P Cossman | 38 Crown St, New Haven, CT 06510-3346 | Controlled Substance Registration for Practitioner | 2015-03-01 ~ 2017-02-28 |
Please comment or provide details below to improve the information on JACK B FRALINGER MD.
| 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).