JOSE MANUEL N TAN MD (Credential# 542066) is licensed (Physician/surgeon) with Connecticut Department of Consumer Protection. The license effective date is July 1, 2012. The license expiration date date is June 30, 2013. The license status is INACTIVE.
JOSE MANUEL N TAN MD is licensed with the Department of Consumer Protection of Connecticut. The credential number is #1.016788. The credential type is physician/surgeon. The effective date is July 1, 2012. The expiration date is June 30, 2013. The business address is 735 Daniels Farm Rd, Trumbull, CT 06611. The current status is inactive.
| Licensee Name | JOSE MANUEL N TAN MD |
| Credential ID | 542066 |
| Credential Number | 1.016788 |
| Credential Type | Physician/Surgeon |
| Business Address |
735 Daniels Farm Rd Trumbull CT 06611 |
| Business Type | INDIVIDUAL |
| Status | INACTIVE - LAPSED DUE TO NON-RENEWAL |
| Issue Date | 1974-08-09 |
| Effective Date | 2012-07-01 |
| Expiration Date | 2013-06-30 |
| Refresh Date | 2013-10-08 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 145106 | CSP.0006709 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 2011-03-01 - 2013-02-28 | INACTIVE |
| Street Address | 735 DANIELS FARM RD |
| City | TRUMBULL |
| State | CT |
| Zip Code | 06611 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Fely C Tan | 735 Daniels Farm Rd, Trumbull, CT 06611 | Physician/surgeon | 1999-10-14 ~ 2000-07-31 |
| 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 | Physician/Surgeon |
| License Type + County | Physician/Surgeon + TRUMBULL |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Alonso, Jose, Manuel, Md, Phd · Uconn Lab of Jose Manuel Alonso Md Phd | 406 Babbidge Road, Storrs, CT 06269-1020 | Controlled Substance Laboratory | 2002-02-01 ~ 2003-01-31 |
| Jose Manuel Paez | 230 S Frontage Rd, New Haven, CT 06519-1124 | Resident Physician | 2020-07-01 ~ 2021-06-30 |
| Jose Manuel Rodriguez | 80 Seymour St, Po Box 5037, Hartford, CT 06102-5037 | Resident Physician | 2017-07-01 ~ 2018-06-30 |
| Manuel C Pun | 4 Corporate Dr Ste 100, Shelton, CT 06484-6258 | Physician/surgeon | 2020-07-01 ~ 2021-06-30 |
| Manuel Tanguma | 956 Woodlake Dr, Cardiff By The Sea, CA 92007 | Physician/surgeon | ~ |
| Manuel Del Sol | 6 Mark Drive, Norwalk, CT 06851 | Physician/surgeon | ~ 1999-01-31 |
| Manuel Cerqueria | Nuclear Medicine, Seattle, WA 98504 | Physician/surgeon | 1980-03-24 ~ 1983-11-30 |
| Manuel R Rosales | 70 Short Way, Roslyn Heights, NY 11577 | Physician/surgeon | ~ 1998-01-31 |
| Manuel J Soares | 684 Farmington Ave, West Hartford, CT 06119 | Physician/surgeon | 1994-08-15 ~ 1995-08-31 |
| Manuel F Rosado | 14 Reservoir Drive, Clinton, CT 06413 | Physician/surgeon | 2009-03-23 ~ 2010-03-31 |
Please comment or provide details below to improve the information on JOSE MANUEL N TAN 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).