ILYA BLOKH MD
Physician/surgeon


Address: 2483 W16th St Apt 8g, Brooklyn, NY 11214

ILYA BLOKH MD (Credential# 561517) is licensed (Physician/surgeon) with Connecticut Department of Consumer Protection. The license effective date is July 7, 2006. The license expiration date date is August 31, 2007. The license status is INACTIVE.

Business Overview

ILYA BLOKH MD is licensed with the Department of Consumer Protection of Connecticut. The credential number is #1.043935. The credential type is physician/surgeon. The effective date is July 7, 2006. The expiration date is August 31, 2007. The business address is 2483 W16th St Apt 8g, Brooklyn, NY 11214. The current status is inactive.

Basic Information

Licensee Name ILYA BLOKH MD
Credential ID 561517
Credential Number 1.043935
Credential Type Physician/Surgeon
Business Address 2483 W16th St Apt 8g
Brooklyn
NY 11214
Business Type INDIVIDUAL
Status INACTIVE - LAPSED DUE TO NON-RENEWAL
Issue Date 2005-11-16
Effective Date 2006-07-07
Expiration Date 2007-08-31
Refresh Date 2009-07-11

Other licenses

ID Credential Code Credential Type Issue Term Status
426198 CSP.0038715 CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER 2005-01-05 2005-01-05 - 2007-02-28 INACTIVE

Office Location

Street Address 2483 W16TH ST APT 8G
City BROOKLYN
State NY
Zip Code 11214

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Competitor

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City BROOKLYN
Zip Code 11214
License Type Physician/Surgeon
License Type + County Physician/Surgeon + BROOKLYN

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Dataset Information

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).

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