EVAN J TILLEY MD
Physician/surgeon


Address: 52 Newton St, Fairfield, CT 06824-6926

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.

Business Overview

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.

Basic Information

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

Other licenses

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

Office Location

Street Address 52 NEWTON ST
City FAIRFIELD
State CT
Zip Code 06824-6926

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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
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Competitor

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City FAIRFIELD
Zip Code 06824
License Type Physician/Surgeon
License Type + County Physician/Surgeon + FAIRFIELD

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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
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Dataset Information

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).

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