BRIAN M DE LA ROSA MD (Credential# 558141) is licensed (Physician/surgeon) with Connecticut Department of Consumer Protection. The license effective date is July 1, 2020. The license expiration date date is June 30, 2021. The license status is ACTIVE.
BRIAN M DE LA ROSA MD is licensed with the Department of Consumer Protection of Connecticut. The credential number is #1.040558. The credential type is physician/surgeon. The effective date is July 1, 2020. The expiration date is June 30, 2021. The business address is 4 Mallett Dr, Trumbull, CT 06611. The current status is active.
| Licensee Name | BRIAN M DE LA ROSA MD |
| Credential ID | 558141 |
| Credential Number | 1.040558 |
| Credential Type | Physician/Surgeon |
| Business Address |
4 Mallett Dr Trumbull CT 06611 |
| Business Type | INDIVIDUAL |
| Status | ACTIVE - CURRENT |
| Active | 1 |
| Issue Date | 2002-06-21 |
| Effective Date | 2020-07-01 |
| Expiration Date | 2021-06-30 |
| Refresh Date | 2020-06-02 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 323695 | CSP.0032883 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 2002-10-28 | 2019-03-01 - 2021-02-28 | ACTIVE |
| Street Address | 4 MALLETT DR |
| City | TRUMBULL |
| State | CT |
| Zip Code | 06611 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Ashley S Balestriere | 7 Sutton Place, Trumbull, CT 06611 | Registered Nurse | 2020-08-01 ~ 2021-07-31 |
| Filomena L Ferraro · Nicolia | 35 Skating Pond Rd, Trumbull, CT 06611 | Registered Nurse | 2020-09-01 ~ 2021-08-31 |
| Alexis Grace Shaub | 58 Chestnut Hill Road, Trumbull, CT 06611 | Physician Assistant | 2020-08-01 ~ 2021-07-31 |
| Maria Bivona | 5302 Main Street, Trumbull, CT 06611 | Notary Public Appointment | 2020-10-01 ~ 2025-09-30 |
| Gina M Gallo · Liquigli | 20 Red Maple Lane, Trumbull, CT 06611 | Hairdresser/cosmetician | 2020-09-01 ~ 2022-08-31 |
| Xuehuan Zhang | 31 Asbury Rd, Trumbull, CT 06611 | Combination Nail Technician, Esthetician Or Eyelash Technici | ~ |
| Antoinette D Senior | 38 Tanager Lane, Trumbull, CT 06611 | Registered Nurse | 2020-07-01 ~ 2021-06-30 |
| Solution Construction LLC | 3 Stonewall Lane, Trumbull, CT 06611 | New Home Construction Contractor | 2020-06-18 ~ 2021-09-30 |
| Gary T Sorge | 63 Limerick Road, Trumbull, CT 06611 | Landscape Architect | 2020-08-01 ~ 2021-07-31 |
| Melodie T Noga | 55 Moose Hill Road, Trumbull, CT 06611 | Real Estate Salesperson | 2020-06-19 ~ 2021-05-31 |
| Find all Licenses in zip 06611 | |||
| City | TRUMBULL |
| Zip Code | 06611 |
| License Type | Physician/Surgeon |
| License Type + County | Physician/Surgeon + TRUMBULL |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Ute W Rosa | 20 Pierrepont St Apt 3c, Brooklyn, NY 11201-7204 | Physician/surgeon | 2017-03-01 ~ 2018-02-28 |
| Rosa E Enriquez | 300 Kensington Ave, New Britain, CT 06051 | Physician/surgeon | 1995-07-03 ~ 1996-07-31 |
| Waseem Ahmed | Santa Rosa, CA 95409 | Physician/surgeon | 2009-09-18 ~ 2010-06-30 |
| Joseph A Rosa | 112 Quarry Rd Ste 250, Trumbull, CT 06611-4877 | Physician/surgeon | 2020-06-01 ~ 2021-05-31 |
| Rosa A. Fini | 4 Dewart Rd, Greenwich, CT 06830-3417 | Physician/surgeon | 2020-03-01 ~ 2021-02-28 |
| Robert M Rosa | 93 Longwood Ave, Brookline, MA 02146 | Physician/surgeon | 1971-08-31 ~ 1980-12-31 |
| Shafqat M Akhtar | P.o.box 12068, Santa Rosa, CA 95406-2068 | Physician/surgeon | 2017-06-01 ~ 2018-05-31 |
| Richard K Shaw | 12 Villa Rosa Terrace, Milford, CT 06460 | Physician/surgeon | 2016-08-01 ~ 2017-07-31 |
| Rosa E G Hendler | 543 Muirfield Lane, West Haven, CT 06516 | Physician/surgeon | 2011-02-01 ~ 2012-01-31 |
| Rodney D Dorand | 58 Dunetop Ter, Santa Rosa Beach, FL 32459-5144 | Physician/surgeon | 2019-10-01 ~ 2020-09-30 |
Please comment or provide details below to improve the information on BRIAN M DE LA ROSA MD.
| 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).