GREGORY S BLOOM MD (Credential# 463873) 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.
GREGORY S BLOOM MD is licensed with the Department of Consumer Protection of Connecticut. The credential number is #CSP.0041156. 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 112 Quarry Rd Ste 400, Trumbull, CT 06611. The current status is active.
| Licensee Name | GREGORY S BLOOM MD |
| Credential ID | 463873 |
| Credential Number | CSP.0041156 |
| Credential Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| Business Address |
112 Quarry Rd Ste 400 Trumbull CT 06611 |
| Business Type | INDIVIDUAL |
| Status | ACTIVE - CURRENT |
| Active | 1 |
| Issue Date | 2007-02-28 |
| Effective Date | 2019-03-01 |
| Expiration Date | 2021-02-28 |
| Refresh Date | 2019-01-31 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 562683 | 1.045101 | Physician/Surgeon | 2007-02-01 | 2019-11-01 - 2020-10-31 | ACTIVE |
| Street Address | 112 QUARRY RD STE 400 |
| City | TRUMBULL |
| State | CT |
| Zip Code | 06611 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Kevin K Lenhart | 112 Quarry Rd Ste 400, Trumbull, CT 06611-4877 | Physician/surgeon | 2020-04-01 ~ 2021-03-31 |
| Charles Landau Md | 112 Quarry Rd Ste 400, Trumbull, CT 06611 | Physician/surgeon | 2020-04-01 ~ 2021-03-31 |
| Alon Ronen Md | 112 Quarry Rd Ste 400, Trumbull, CT 06611-4816 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Sik Hur | 112 Quarry Rd Ste 400, Trumbull, CT 06611-4816 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Ashley S Balestriere | 7 Sutton Place, Trumbull, CT 06611 | Registered Nurse | 2020-08-01 ~ 2021-07-31 |
| Filomena L Ferraro · Nicolia | 35 Skating Pond Rd, Trumbull, CT 06611 | Registered Nurse | 2020-09-01 ~ 2021-08-31 |
| Alexis Grace Shaub | 58 Chestnut Hill Road, Trumbull, CT 06611 | Physician Assistant | 2020-08-01 ~ 2021-07-31 |
| Maria Bivona | 5302 Main Street, Trumbull, CT 06611 | Notary Public Appointment | 2020-10-01 ~ 2025-09-30 |
| Gina M Gallo · Liquigli | 20 Red Maple Lane, Trumbull, CT 06611 | Hairdresser/cosmetician | 2020-09-01 ~ 2022-08-31 |
| Xuehuan Zhang | 31 Asbury Rd, Trumbull, CT 06611 | Combination Nail Technician, Esthetician Or Eyelash Technici | ~ |
| Antoinette D Senior | 38 Tanager Lane, Trumbull, CT 06611 | Registered Nurse | 2020-07-01 ~ 2021-06-30 |
| Solution Construction LLC | 3 Stonewall Lane, Trumbull, CT 06611 | New Home Construction Contractor | 2020-06-18 ~ 2021-09-30 |
| Gary T Sorge | 63 Limerick Road, Trumbull, CT 06611 | Landscape Architect | 2020-08-01 ~ 2021-07-31 |
| Melodie T Noga | 55 Moose Hill Road, Trumbull, CT 06611 | Real Estate Salesperson | 2020-06-19 ~ 2021-05-31 |
| Find all Licenses in zip 06611 | |||
| City | TRUMBULL |
| Zip Code | 06611 |
| License Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| License Type + County | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER + TRUMBULL |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Todd E Bloom | 760 Kings Hwy W, Southport, CT 06890-1107 | Controlled Substance Registration for Practitioner | 2019-04-01 ~ 2021-02-28 |
| Justin R. Bloom | Po Box 806, East Windsor, CT 06088 | 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 |
| David I Bloom Md | 2 Bridge Lane, Enfield, CT 06083 | Controlled Substance Registration for Practitioner | ~ |
| Katherine A Bloom | 55 Walls Drive, Fairfield, CT 06824 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Maxine Bloom | 14 Bauer Place, Westport, CT 06880-2138 | 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 |
| David I Bloom Jr | 1060 Day Hill Road, Windsor, CT 06095 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Gregory J Lyddy Dds | 55 Elm St, Fairfield, CT 06824 | Controlled Substance Registration for Practitioner | 2008-03-01 ~ 2009-02-28 |
| Gregory T. Lee | 8 Spruce St Apt 33f, New York, NY 10038-5224 | Controlled Substance Registration for Practitioner | 2015-03-01 ~ 2017-02-28 |
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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).