JERRY D BALLARD (Credential# 546594) is licensed (Physician/surgeon) with Connecticut Department of Consumer Protection. The license effective date is June 12, 1995. The license expiration date date is July 31, 1996. The license status is INACTIVE.
JERRY D BALLARD is licensed with the Department of Consumer Protection of Connecticut. The credential number is #1.027459. The credential type is physician/surgeon. The effective date is June 12, 1995. The expiration date is July 31, 1996. The business address is 165 Jeffrey Lane, Springfield, MA 01089. The current status is inactive.
| Licensee Name | JERRY D BALLARD |
| Credential ID | 546594 |
| Credential Number | 1.027459 |
| Credential Type | Physician/Surgeon |
| Business Address |
165 Jeffrey Lane Springfield MA 01089 |
| Business Type | INDIVIDUAL |
| Status | INACTIVE - LAPSED DUE TO NON-RENEWAL |
| Issue Date | 1986-07-24 |
| Effective Date | 1995-06-12 |
| Expiration Date | 1996-07-31 |
| Refresh Date | 2009-07-08 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 164299 | CSP.0022264 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 1994-07-06 - 1996-07-01 | INACTIVE |
| Street Address | 165 JEFFREY LANE |
| City | SPRINGFIELD |
| State | MA |
| Zip Code | 01089 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Darlene A Kurman | 158 Edgewood Rd, W Springfield, MA 01089 | Registered Nurse | 2020-08-01 ~ 2021-07-31 |
| Jessica Marquez | 758 Westfield St, West Springfield, MA 01089 | Licensed Clinical Social Worker | ~ |
| Jody L Russell | 121 Greenleaf Ave, West Springfield, MA 01089 | Registered Nurse | 2020-07-01 ~ 2021-06-30 |
| Katherine Zemanek | 81 Braintree Road, West Springfield, MA 01089 | Registered Nurse | 2020-08-01 ~ 2021-07-31 |
| John Calabrese | 64 High Meadow Dr, West Springfield, MA 01089 | Dentist | ~ |
| Mary Christine Matias | 24 Appaloosa Lane, West Springfield, MA 01089 | Licensed Practical Nurse | ~ |
| Elizabeth A Favreau | 21 Hummingbird Lane, West Springfield, MA 01089 | Registered Nurse | 2020-09-01 ~ 2021-08-31 |
| James M Hanifan | 90 Bayberry Ln, W Springfield, MA 01089 | Architect | 2020-08-01 ~ 2021-07-31 |
| Katie Marie Sniegowski | 22 Garden St, West Springfield, MA 01089 | Registered Nurse - Temporary | 2020-02-05 ~ 2020-06-04 |
| Surgi-care Inc | 150 Doty Cir, West Springfield, MA 01089 | Wholesaler of Drugs, Cosmetics & Medical Devices | 2020-07-01 ~ 2021-06-30 |
| Find all Licenses in zip 01089 | |||
| City | SPRINGFIELD |
| Zip Code | 01089 |
| License Type | Physician/Surgeon |
| License Type + County | Physician/Surgeon + SPRINGFIELD |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Jason M Kittler | 10 Ballard Ave, Pittsfield, MA 01201 | Physician/surgeon | 2006-02-27 ~ 2007-02-28 |
| Jennifer Elizabeth Ballard | 4023 Kennett Pike # 50330, Wilmington, DE 19807-2018 | Physician/surgeon | 2020-04-01 ~ 2021-03-31 |
| Jerry Harwood Md | 51 Forest Ave No. 105, Old Greenwich, CT 06870 | Physician/surgeon | 1998-06-29 ~ 1999-06-30 |
| Jerry L Greenburg | 456 Water St, Celebration, FL 34747-4977 | Physician/surgeon | 2020-04-01 ~ 2021-03-31 |
| Jerry J Thomas | 1065 Us Highway 22 Ste 3d, Bridgewater, NJ 08807-2949 | Physician/surgeon | 2010-08-01 ~ 2011-07-31 |
| Jerry Goldfarb Md | 30 Brodwood Drive, Stamford, CT 06902 | Physician/surgeon | 1999-08-26 ~ 2000-08-31 |
| Jerry J Jaboin Md | 24 Ladue Mnr, Saint Louis, MO 63124-1821 | Physician/surgeon | 2012-08-01 ~ 2013-07-31 |
| Jerry Sheen | 510-3d Auten Road, Hillsborough, NJ 08844 | Physician/surgeon | 2004-12-13 ~ 2005-03-31 |
| H Paul Winalski Md | 186 Jerry Browne Road, Mystic, CT 06355 | Physician/surgeon | 2010-04-01 ~ 2011-03-31 |
| James N Worcester | 186 Jerry Browne Road, Mystic, CT 06355 | Physician/surgeon | 2006-09-05 ~ 2007-07-31 |
Please comment or provide details below to improve the information on JERRY D BALLARD.
| 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).