REZA T JALAL MD (Credential# 553098) is licensed (Physician/surgeon) with Connecticut Department of Consumer Protection. The license effective date is September 19, 1997. The license expiration date date is September 30, 1998. The license status is INACTIVE.
REZA T JALAL MD is licensed with the Department of Consumer Protection of Connecticut. The credential number is #1.035505. The credential type is physician/surgeon. The effective date is September 19, 1997. The expiration date is September 30, 1998. The business address is 67 Village Lane, Wethersfield, CT 06109. The current status is inactive.
| Licensee Name | REZA T JALAL MD |
| Credential ID | 553098 |
| Credential Number | 1.035505 |
| Credential Type | Physician/Surgeon |
| Business Address |
67 Village Lane Wethersfield CT 06109 |
| Business Type | INDIVIDUAL |
| Status | INACTIVE - LAPSED DUE TO NON-RENEWAL |
| Issue Date | 1996-08-23 |
| Effective Date | 1997-09-19 |
| Expiration Date | 1998-09-30 |
| Refresh Date | 2009-07-11 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 177618 | CSP.0024731 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 1997-03-01 - 1998-02-28 | INACTIVE |
| Street Address | 67 VILLAGE LANE |
| City | WETHERSFIELD |
| State | CT |
| Zip Code | 06109 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Nishant Patel Md | 67 Village Lane, Wethersfield, CT 06109 | Controlled Substance Registration for Practitioner | 2013-03-01 ~ 2015-02-28 |
| Darryl L Smith | 67 Village Lane, Wethersfield, CT 06109 | Respiratory Care Practitioner | 2002-08-05 ~ 2003-09-30 |
| Jennifer M Young | 67 Village Lane, Wethersfield, CT 06109 | Registered Nurse | 2000-10-10 ~ 2001-02-28 |
| Vito L Modugno | 67 Village Lane, Wethersfield, CT 06109 | Dental Anesthesia/conscious Sedation Permit | ~ 1996-12-28 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Susan E Dimauro | 330 Ridge Rd, Wethersfield, CT 06109 | Registered Nurse | 2020-07-01 ~ 2021-06-30 |
| Mary Boccacio | 174 Longvue Drive, Wethersfield, CT 06109 | Esthetician | ~ |
| Steven C Hine | 294 Hang Dog Ln, Wethersfield, CT 06109 | Architect | 2020-08-01 ~ 2021-07-31 |
| Karolina Monika Fitrzyk | 41 Mountain Laurel, Wethersfield, CT 06109 | Combination Nail Technician, Esthetician Or Eyelash Technici | ~ |
| Matthew R Dobos | 33 Oxford St, Wethersfield, CT 06109 | Registered Nurse | 2020-07-01 ~ 2021-06-30 |
| Samantha Grabbe | 17 Rockland St, Wethersfield, CT 06109 | Registered Nurse | 2020-08-01 ~ 2021-07-31 |
| Judith M Martz | 307 Nott Street, Wethersfield, CT 06109 | Licensed Practical Nurse | 2020-07-01 ~ 2021-06-30 |
| Ups Store (the) | 1077 Silas Deane Hwy, Wethersfield, CT 06109 | Operator of Weighing & Measuring Devices | 2020-08-01 ~ 2021-07-31 |
| Amber H Washington | 103 Parkview Drive, Wethersfield, CT 06109 | Hairdresser/cosmetician | 2020-09-01 ~ 2022-08-31 |
| Kathleen A Mullady · Brancati | 75 Dale Rd, Wethersfield, CT 06109 | Registered Nurse | 2020-07-01 ~ 2021-06-30 |
| Find all Licenses in zip 06109 | |||
| City | WETHERSFIELD |
| Zip Code | 06109 |
| License Type | Physician/Surgeon |
| License Type + County | Physician/Surgeon + WETHERSFIELD |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Syed H Reza | 346 Main Ave Ste B, Norwalk, CT 06851-1592 | Physician/surgeon | 2020-05-01 ~ 2021-04-30 |
| Ali Reza Rahimi | 1450 Chapel St, New Haven, CT 06511-4405 | Physician/surgeon | 1990-07-13 ~ 1991-05-31 |
| Hamid Reza Abbasi | 6600 Mn-29, Alexandria, MN 56308 | Physician/surgeon | 2020-04-02 ~ 2020-11-30 |
| Abdur Reza Khan | 3442 Foothill Blvd, La Crescenta, CA 91214 | Physician/surgeon | ~ |
| Afshin Reza Sam | 22314 Town Walk Drive, Hamden, CT 06518 | Physician/surgeon | 2009-04-27 ~ 2010-05-31 |
| Hamid Reza Danesh | 1431 Pawtucket Blvd, Lowell, MA 01854 | Physician/surgeon | 2005-09-01 ~ 2006-03-31 |
| Reza Milano | 267 Grand St., Bridgeport, CT 06610 | Resident Physician | 2018-06-25 ~ 2021-06-30 |
| Jalal Shirazifard | 15 Brightside Dr, Stamford, CT 06902-8107 | Radiographer | 2015-10-01 ~ 2016-09-30 |
| Jalal Gohari | 69 28 68th Pl, Glendale, NY 11385 | Professional Engineer | 2017-02-01 ~ 2018-01-31 |
| Jalal Faraj | 564 Adams St, Manchester, CT 06040-2711 | Pharmacy Technician | 2018-03-06 ~ 2019-03-31 |
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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).