THEODORE A BLAINE (Credential# 556655) is licensed (Physician/surgeon) with Connecticut Department of Consumer Protection. The license effective date is August 1, 2020. The license expiration date date is July 31, 2021. The license status is ACTIVE.
THEODORE A BLAINE is licensed with the Department of Consumer Protection of Connecticut. The credential number is #1.039067. The credential type is physician/surgeon. The effective date is August 1, 2020. The expiration date is July 31, 2021. The business address is 16 Marshall Street, Old Greenwich, CT 06870. The current status is active.
Licensee Name | THEODORE A BLAINE |
Credential ID | 556655 |
Credential Number | 1.039067 |
Credential Type | Physician/Surgeon |
Business Address |
16 Marshall Street Old Greenwich CT 06870 |
Business Type | INDIVIDUAL |
Status | ACTIVE - CURRENT |
Active | 1 |
Issue Date | 2000-10-16 |
Effective Date | 2020-08-01 |
Expiration Date | 2021-07-31 |
Refresh Date | 2020-05-18 |
ID | Credential Code | Credential Type | Issue | Term | Status |
---|---|---|---|---|---|
293241 | CSP.0031679 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 2001-12-11 | 2019-03-01 - 2021-02-28 | ACTIVE |
Street Address | 16 Marshall Street |
City | Old Greenwich |
State | CT |
Zip Code | 06870 |
Licensee Name | Office Address | Credential | Effective / Expiration |
---|---|---|---|
Erin Kelly Walsh | 20 W End, Old Greenwich, CT 06870 | Controlled Substance Registration for Practitioner | 2020-06-25 ~ 2021-02-28 |
Geraldine Smeriglio | 15 Saint Claire Avenue, Old Greenwich, CT 06870 | Real Estate Salesperson | ~ |
Ellington Enhanced Income Fund Ltd. | C/o Ellington Global Asset Management, Old Greenwich, CT 06870 | Securities - Exemptions | 2020-06-17 ~ |
Hiba Kamar Hussain | 7 Richmond Drive, Old Greenwich, CT 06870 | Emergency Medical Technician | ~ |
Old Greenwich Bagel Shop Inc | 197 Soundbeach Ave, Old Greenwich, CT 06870 | Bakery | 2020-07-01 ~ 2021-06-30 |
Juliana Mendes Napolitano Serrao | 3 Tait Road, Old Greenwich, CT 06870 | Real Estate Salesperson | 2020-06-01 ~ 2021-05-31 |
Robert N Rouleau | 205 Shore Road, Old Greenwich, CT 06870 | Architect | 2020-08-01 ~ 2021-07-31 |
Charles W Ginste Jr | 44 Tomac Avenue, Old Greenwich, CT 06870 | Architect | 2020-08-01 ~ 2021-07-31 |
Susan R Alisberg | Alisberg Parker Architects, Old Greenwich, CT 06870 | Architect | 2020-08-01 ~ 2021-07-31 |
Leander G Krueger | 19 Meadow Place, Old Greenwich, CT 06870 | Architect | 2020-08-01 ~ 2021-07-31 |
Find all Licenses in zip 06870 |
City | Old Greenwich |
Zip Code | 06870 |
License Type | Physician/Surgeon |
License Type + County | Physician/Surgeon + Old Greenwich |
Licensee Name | Office Address | Credential | Effective / Expiration |
---|---|---|---|
Blaine E Messing Md | 28 Cross Hwy, Westport, CT 06880-2140 | Physician/surgeon | 2020-06-01 ~ 2021-05-31 |
Kyle P Nielson | 1300 Boblett St # 374, Blaine, WA 98230-9716 | Physician/surgeon | 2016-02-01 ~ 2017-01-31 |
Charles J Kopriva | 1250 Blaine Street, Port Townsend, WA 98368 | Physician/surgeon | 2014-08-01 ~ 2015-07-31 |
Curtis Blaine Pickert | 1301 Concord Terrace, Sunrise, FL 33323 | Physician/surgeon | 2020-01-01 ~ 2020-12-31 |
Theodore Nowakiwskys | CT | Physician/surgeon | ~ |
Theodore D Fishman Md | 670 Prospect Ave, Hartford, CT 06105 | Physician/surgeon | 2020-06-01 ~ 2021-05-31 |
Theodore Lidz | 60 Orchard Rd, Woodbridge, CT 06525 | Physician/surgeon | 1995-02-07 ~ 1996-04-30 |
Theodore Johnson | 310 Seabury Dr, Bloomfield, CT 06002-2657 | Physician/surgeon | 2017-07-01 ~ 2018-06-30 |
Theodore H Schettler | 124 Peterborough St, Boston, MA 02215 | Physician/surgeon | 1996-07-22 ~ 1997-07-31 |
Theodore J Degroot | 53 Lafayette St, Norwich, CT 06360 | Physician/surgeon | 1996-10-28 ~ 1997-12-31 |
Please comment or provide details below to improve the information on THEODORE A BLAINE.
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).