MARY W CHANG (Credential# 560567) is licensed (Physician/surgeon) with Connecticut Department of Consumer Protection. The license effective date is September 1, 2020. The license expiration date date is August 31, 2021. The license status is ACTIVE.
MARY W CHANG is licensed with the Department of Consumer Protection of Connecticut. The credential number is #1.042985. The credential type is physician/surgeon. The effective date is September 1, 2020. The expiration date is August 31, 2021. The business address is 28 Pebble Beach Drive, Bloomfield, CT 06002. The current status is active.
Licensee Name | MARY W CHANG |
Credential ID | 560567 |
Credential Number | 1.042985 |
Credential Type | Physician/Surgeon |
Business Address |
28 Pebble Beach Drive Bloomfield CT 06002 |
Business Type | INDIVIDUAL |
Status | ACTIVE - CURRENT |
Active | 1 |
Issue Date | 2004-12-09 |
Effective Date | 2020-09-01 |
Expiration Date | 2021-08-31 |
Refresh Date | 2020-06-13 |
ID | Credential Code | Credential Type | Issue | Term | Status |
---|---|---|---|---|---|
393832 | CSP.0036935 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 2005-01-13 | 2019-03-01 - 2021-02-28 | ACTIVE |
Street Address | 28 Pebble Beach Drive |
City | Bloomfield |
State | CT |
Zip Code | 06002 |
Licensee Name | Office Address | Credential | Effective / Expiration |
---|---|---|---|
Paula L Raines | 92 Daniel Blvd, Bloomfield, CT 06002 | Licensed Practical Nurse | 2020-07-01 ~ 2021-06-30 |
Kesone Taletia Telfer | 36 Walsh Street, Bloomfield, CT 06002 | Advanced Practice Registered Nurse | ~ |
Joan Zito Upton | 106 Duncaster Road, Bloomfield, CT 06002 | Dental Hygienist | 2020-08-01 ~ 2021-07-31 |
Sheri M Sparks | Primary Eye Care Center, Bloomfield, CT 06002 | Optometrist | 2020-09-01 ~ 2021-08-31 |
Kaman Aerospace Corporation | Old Windsor Road, Bloomfield, CT 06002 | Operator of Weighing & Measuring Devices | 2020-08-01 ~ 2021-07-31 |
Healing Meals Foundation Corporation | Po Box 7223, Bloomfield, CT 06002 | Public Charity | 2020-12-01 ~ 2021-11-30 |
Taylor A West | 5 Tiffany Ln, Bloomfield, CT 06002 | Registered Nurse | 2020-07-01 ~ 2021-06-30 |
Emma J Ranel | 53 Burr Road, Bloomfield, CT 06002 | Licensed Practical Nurse | 2020-07-01 ~ 2021-06-30 |
Dorothy W Field | 177 Oliver Way, Bloomfield, CT 06002 | Registered Nurse | 2020-09-01 ~ 2021-08-31 |
Carol J Mortensen | 6 Maple Edge Dr, Bloomfield, CT 06002 | Registered Nurse | 2020-07-01 ~ 2021-06-30 |
Find all Licenses in zip 06002 |
City | Bloomfield |
Zip Code | 06002 |
License Type | Physician/Surgeon |
License Type + County | Physician/Surgeon + Bloomfield |
Licensee Name | Office Address | Credential | Effective / Expiration |
---|---|---|---|
Chang R. Na | 925 Mix Ave Apt 1p, Hamden, CT 06514-5119 | Physician/surgeon | 2013-03-01 ~ 2014-02-28 |
Sandy Chang | Madison, CT 06443 | Physician/surgeon | 2020-05-01 ~ 2021-04-30 |
Yu C Chang | 209-42 30th Ave., Bayside, NY 11360-2419 | Physician/surgeon | 2006-07-12 ~ 2007-08-31 |
Robert Y Chang Md | 35 Elm St, New Haven, CT 06510 | Physician/surgeon | 2020-06-01 ~ 2021-05-31 |
Tina Yin Chang | 701 5th Ave, Seattle, WA 98104 | Physician/surgeon | 2020-05-01 ~ 2021-04-30 |
Chunghun Chang | 2 Doris Dr, Scarsdale, NY 10583-2712 | Physician/surgeon | 2016-07-01 ~ 2017-06-30 |
Stanley Chang | 79 Greenacres Ave, Scarsdale, NY 10583 | Physician/surgeon | 2003-09-22 ~ 2004-09-30 |
Winshih Chang | 664 Stoneleigh Ave Ste 300, Carmel, NY 10512-3990 | Physician/surgeon | 2016-11-09 ~ 2017-08-31 |
Nam Sik Chang | Scott Dr, South Windsor, CT 06074 | Physician/surgeon | 1981-01-01 ~ 1987-09-22 |
Joann C Chang | 4 Liberty Sq, Littleton, MA 01460-2002 | Physician/surgeon | 2018-12-01 ~ 2019-11-30 |
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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).