EVAN J TILLEY MD (Credential# 543535) is licensed (Physician/surgeon) with Connecticut Department of Consumer Protection. The license effective date is April 1, 2018. The license expiration date date is March 31, 2019. The license status is INACTIVE.
EVAN J TILLEY MD is licensed with the Department of Consumer Protection of Connecticut. The credential number is #1.021012. The credential type is physician/surgeon. The effective date is April 1, 2018. The expiration date is March 31, 2019. The business address is 52 Newton St, Fairfield, CT 06824-6926. The current status is inactive.
Licensee Name | EVAN J TILLEY MD |
Credential ID | 543535 |
Credential Number | 1.021012 |
Credential Type | Physician/Surgeon |
Business Address |
52 Newton St Fairfield CT 06824-6926 |
Business Type | INDIVIDUAL |
Status | INACTIVE - LAPSED DUE TO NON-RENEWAL |
Issue Date | 1979-01-08 |
Effective Date | 2018-04-01 |
Expiration Date | 2019-03-31 |
Refresh Date | 2019-07-04 |
ID | Credential Code | Credential Type | Issue | Term | Status |
---|---|---|---|---|---|
159819 | CSP.0017350 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 1999-05-14 | 2017-03-01 - 2019-02-28 | LAPSED |
Street Address | 52 NEWTON ST |
City | FAIRFIELD |
State | CT |
Zip Code | 06824-6926 |
Licensee Name | Office Address | Credential | Effective / Expiration |
---|---|---|---|
Amy S Van Buren | 11 Larkspur Road, Fairfield, CT 06824 | Massage Therapist | 2020-08-01 ~ 2022-07-31 |
Linda J Batchelder | 72 Ruane St, Fairfield, CT 06824 | Architect | 2020-08-01 ~ 2021-07-31 |
Fairfield American Little League | 87 Charles St, Fairfield, CT 06824 | Public Charity | 2020-12-01 ~ 2021-11-30 |
Robert D Sickeler | 175 Wakeman Rd, Fairfield, CT 06824 | Architect | 2020-08-01 ~ 2021-07-31 |
Michael P Brennan | 338 Sturges Rd, Fairfield, CT 06824 | Real Estate Salesperson | 2020-06-23 ~ 2021-05-31 |
Maria A Arduini | 499 Hemlock Rd, Fairfield, CT 06824 | Real Estate Salesperson | 2020-06-23 ~ 2021-05-31 |
Ryan L Antisdale | 104 Rhoda Avenue, Fairfield, CT 06824 | Real Estate Salesperson | 2020-06-23 ~ 2021-05-31 |
Szymlinska Eva Jucelin | 105 Churchill Street, Fairfield, CT 06824 | Licensed Practical Nurse | 2020-07-01 ~ 2021-06-30 |
Afoofa, Inc · Afoofa | 298 South Benson Road, Fairfield, CT 06824 | Public Charity-exempt From Financial Requirements | 2020-06-25 ~ |
Rachel Finlaw | 2546 North Benson Road, Fairfield, CT 06824 | Master's Level Social Worker | ~ |
Find all Licenses in zip 06824 |
City | FAIRFIELD |
Zip Code | 06824 |
License Type | Physician/Surgeon |
License Type + County | Physician/Surgeon + FAIRFIELD |
Licensee Name | Office Address | Credential | Effective / Expiration |
---|---|---|---|
Evan M Ginsberg | Po Box 530, Winhall, VT 05340-0530 | Physician/surgeon | 2020-05-01 ~ 2021-04-30 |
Evan Kurz | 59 Rymph Rd, Lagrangeville, NY 12540 | Physician/surgeon | 2020-04-01 ~ 2021-03-31 |
Evan Wasserman Md | 34 Maple St, Norwalk, CT 06850-3815 | Physician/surgeon | 2020-07-01 ~ 2021-06-30 |
Joseph M Pruner | 111 Evan Rd, Southington, CT 06489-4107 | Physician/surgeon | 2020-05-01 ~ 2021-04-30 |
Evan Fox | 300 Hebron Avenue, Glastonbury, CT 06033 | Physician/surgeon | 2019-12-01 ~ 2020-11-30 |
Evan L Stepp Md | 145 N Lake Dr, Stamford, CT 06903-1009 | Physician/surgeon | 2012-06-01 ~ 2013-05-31 |
Evan P Cohen | 215 E 24th St Apt 110, New York, NY 10010-3808 | Physician/surgeon | 2011-07-27 ~ 2012-07-31 |
Evan M Benjamin | Ihs Hospital, Zuni, NM 87327 | Physician/surgeon | 1994-03-31 ~ 1995-03-31 |
Evan H Bellin Md | 47 Lispenard Ave, New Rochelle, NY 10801-4420 | Physician/surgeon | 2020-05-01 ~ 2021-04-30 |
Evan Whalley Md | 20-c Heritage Crest, Southbury, CT 06844 | Physician/surgeon | 2000-04-21 ~ 2001-05-31 |
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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).