JEFFREY R GOLDBERG MD (Credential# 553733) is licensed (Physician/surgeon) with Connecticut Department of Consumer Protection. The license effective date is June 1, 2020. The license expiration date date is May 31, 2021. The license status is ACTIVE.
JEFFREY R GOLDBERG MD is licensed with the Department of Consumer Protection of Connecticut. The credential number is #1.036141. The credential type is physician/surgeon. The effective date is June 1, 2020. The expiration date is May 31, 2021. The business address is 25 Collins Rd, Bristol, CT 06010. The current status is active.
| Licensee Name | JEFFREY R GOLDBERG MD |
| Credential ID | 553733 |
| Credential Number | 1.036141 |
| Credential Type | Physician/Surgeon |
| Business Address |
25 Collins Rd Bristol CT 06010 |
| Business Type | INDIVIDUAL |
| Status | ACTIVE - CURRENT |
| Active | 1 |
| Issue Date | 1997-06-27 |
| Effective Date | 2020-06-01 |
| Expiration Date | 2021-05-31 |
| Refresh Date | 2020-03-02 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 182953 | CSP.0025775 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 1999-03-01 | 2019-03-01 - 2021-02-28 | ACTIVE |
| Street Address | 25 COLLINS RD |
| City | BRISTOL |
| State | CT |
| Zip Code | 06010 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Danico Prescriptions Inc | 25 Collins Rd, Bristol, CT 06010-3893 | Wholesaler of Drugs, Cosmetics & Medical Devices | 2020-07-01 ~ 2021-06-30 |
| Jonathan Rosen | 25 Collins Rd, Bristol, CT 06010 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| H Andrew Selinger Md | 25 Collins Rd, Bristol, CT 06010 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Beacon Prescriptions #3 · Danico Prescriptions Inc | 25 Collins Rd, Bristol, CT 06010-3893 | Pharmacy | 2019-09-01 ~ 2020-08-31 |
| Michael J Liftman Md | 25 Collins Rd, Bristol, CT 06010 | Physician/surgeon | 2018-08-01 ~ 2019-07-31 |
| Gab Prescriptions Inc · Beacon Prescriptions | 25 Collins Rd, Bristol, CT 06010 | Wholesaler of Drugs, Cosmetics & Medical Devices | 2013-07-01 ~ 2014-06-30 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Deborah M Dube · Adamaitis | 33 Peck Lane, Bristol, CT 06010 | Licensed Practical Nurse | 2020-07-01 ~ 2021-06-30 |
| Barbara M Williams | 45 Harrison Street, Bristol, CT 06010 | Notary Public Appointment | 2020-08-01 ~ 2025-07-31 |
| Le Bao Linh Nguyen | 229 Silo Rd, Bristol, CT 06010 | Nail Technician | ~ |
| Tara M Chipman | 38 Grove St, Bristol, CT 06010 | Licensed Practical Nurse | 2020-07-01 ~ 2021-06-30 |
| Jaclyn J Brandolini | 424 Emmett St, Bristol, CT 06010 | Registered Nurse | 2020-07-01 ~ 2021-06-30 |
| Hoa Le | 63 Seminary St, Bristol, CT 06010 | Nail Technician | ~ |
| Barbara E Trench | 25 Peacedale St, Bristol, CT 06010 | Hairdresser/cosmetician | 2020-07-01 ~ 2022-06-30 |
| Tisha A Balfour | 379 West Street, Bristol, CT 06010 | Licensed Practical Nurse | 2020-08-01 ~ 2021-07-31 |
| Meredith Rose Martineau | 15 Bishop Street, Bristol, CT 06010 | Master's Level Social Worker - Temporary Permit | 2020-06-26 ~ 2020-09-06 |
| Jaime L Krueger | 130 Garfield Road, Bristol, CT 06010 | Notary Public Appointment | 2020-06-26 ~ 2025-06-30 |
| Find all Licenses in zip 06010 | |||
| City | BRISTOL |
| Zip Code | 06010 |
| License Type | Physician/Surgeon |
| License Type + County | Physician/Surgeon + BRISTOL |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Marc Goldberg Md | 605 West Ave, Norwalk, CT 06850 | Physician/surgeon | 1996-05-24 ~ 1997-05-31 |
| Jana Goldberg | 156 W. 56th Street, New York, NY 08033 | Physician/surgeon | ~ |
| Arnold R. Goldberg | 61 Brook Rd, Sharon, MA 02067-1415 | Physician/surgeon | 1984-05-01 ~ 1985-05-31 |
| Sheldon S Goldberg | 2 Medical Ctr Dr, Springfield, MA 01107 | Physician/surgeon | 1993-06-24 ~ 1994-08-31 |
| Barry Goldberg Md | 17 Hillhouse Ave, New Haven, CT 06520 | Physician/surgeon | 2006-11-03 ~ 2007-12-31 |
| Pablo H Goldberg Md | 501 W 110th St Apt 9c, New York, NY 10025-2060 | Physician/surgeon | 2020-02-01 ~ 2021-01-31 |
| Sarah B Goldberg | 333 Cedar St, Fmp 130, New Haven, CT 06510-3206 | Physician/surgeon | 2020-09-01 ~ 2021-08-31 |
| Joseph F Goldberg Md | 128 East Ave, Norwalk, CT 06851-5738 | Physician/surgeon | 2020-03-01 ~ 2021-02-28 |
| David J Goldberg Md | 87 Linden St, New Haven, CT 06511 | Physician/surgeon | 2005-03-03 ~ 2006-03-31 |
| Heidi E Goldberg | P.o.box 7578, Seminole, FL 33775-7578 | Physician/surgeon | 2006-02-23 ~ 2007-03-31 |
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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).