TODD E BLOOM (Credential# 406349) is licensed (Controlled Substance Registration for Practitioner) with Connecticut Department of Consumer Protection. The license effective date is April 1, 2019. The license expiration date date is February 28, 2021. The license status is ACTIVE.
TODD E BLOOM is licensed with the Department of Consumer Protection of Connecticut. The credential number is #CSP.0037553. The credential type is controlled substance registration for practitioner. The effective date is April 1, 2019. The expiration date is February 28, 2021. The business address is 760 Kings Hwy W, Southport, CT 06890-1107. The current status is active.
| Licensee Name | TODD E BLOOM |
| Credential ID | 406349 |
| Credential Number | CSP.0037553 |
| Credential Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| Business Address |
760 Kings Hwy W Southport CT 06890-1107 |
| Business Type | INDIVIDUAL |
| Status | ACTIVE - CURRENT |
| Active | 1 |
| Issue Date | 2005-06-02 |
| Effective Date | 2019-04-01 |
| Expiration Date | 2021-02-28 |
| Refresh Date | 2019-04-03 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 703728 | 2.009276 | Dentist | 2004-03-22 | 2019-09-01 - 2020-08-31 | ACTIVE |
| 741732 | 22.008430 | Dental Anesthesia/Conscious Sedation Permit | 2005-08-02 | 2019-09-01 - 2020-08-31 | ACTIVE |
| Street Address | 760 KINGS HWY W |
| City | SOUTHPORT |
| State | CT |
| Zip Code | 06890-1107 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Debra A Belanger | 732 Kings Hwy W, Southport, CT 06890-1107 | Marital and Family Therapist | 2020-08-01 ~ 2021-07-31 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Alexander Esposito | 312 High Meadow Rd, Southport, CT 06890 | Architect | 2020-08-01 ~ 2021-07-31 |
| Christina Muller | 243 Sturbridge Lane, Southport, CT 06890 | Licensed Clinical Social Worker | ~ |
| Carmen R Weber | 45 Split Rock Road, Southport, CT 06890 | Dietitian/nutritionist | 2020-09-01 ~ 2021-08-31 |
| Cher A Anderson | 10 Anvil Road, Southport, CT 06890 | Hairdresser/cosmetician | 2020-09-01 ~ 2022-08-31 |
| Christal L T Rodenhiser | 193 Osborne Ln, Southport, CT 06890 | Registered Nurse | 2020-08-01 ~ 2021-07-31 |
| David S Parker | P.o. Box 491, Southport, CT 06890 | Architect | 2020-08-01 ~ 2021-07-31 |
| Peter H Ventriglia | 60 Chester Pl, Southport, CT 06890 | Real Estate Salesperson | 2020-06-16 ~ 2021-05-31 |
| Jennifer Adell Efstathiou | 237 Woodrow Avenue, Southport, CT 06890 | Esthetician | ~ |
| Brenda L Vanfleet | 160 Range Rd, Southport, CT 06890 | Dental Hygienist | 2020-06-01 ~ 2021-05-31 |
| John S Brice | 71 Old Post Rd, Southport, CT 06890 | Architect | 2020-08-01 ~ 2021-07-31 |
| Find all Licenses in zip 06890 | |||
| City | SOUTHPORT |
| Zip Code | 06890 |
| License Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| License Type + County | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER + SOUTHPORT |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Justin R. Bloom | Po Box 806, East Windsor, CT 06088 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Gregory S Bloom Md | 112 Quarry Rd Ste 400, Trumbull, CT 06611 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Peter E Bloom Jr | 25 Newell Rd Ste E36, Bristol, CT 06010-5132 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Katherine A Bloom | 55 Walls Drive, Fairfield, CT 06824 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Jeffrey N Bloom Md | 3020 Westchester Ave Ste 402, Purchase, NY 10577 | Controlled Substance Registration for Practitioner | 2007-03-01 ~ 2008-02-29 |
| Maxine Bloom | 14 Bauer Place, Westport, CT 06880-2138 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| David I Bloom Md | 2 Bridge Lane, Enfield, CT 06083 | Controlled Substance Registration for Practitioner | ~ |
| David I Bloom Jr | 1060 Day Hill Road, Windsor, CT 06095 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Todd J. Ochsner Do | 19 Brainard Rd, Niantic, CT 06357-1722 | Controlled Substance Registration for Practitioner | 2013-03-01 ~ 2015-02-28 |
| Michelene Todd | 250 Scuppo Rd, Woodbury, CT 06798-3822 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
Please comment or provide details below to improve the information on TODD E BLOOM.
| 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).