TARAYN A FAIRLIE (Credential# 912564) is licensed (Physician/surgeon) with Connecticut Department of Consumer Protection. The license effective date is July 1, 2011. The license expiration date date is June 30, 2012. The license status is INACTIVE.
TARAYN A FAIRLIE is licensed with the Department of Consumer Protection of Connecticut. The credential number is #1.048460. The credential type is physician/surgeon. The effective date is July 1, 2011. The expiration date is June 30, 2012. The business address is 1476 Crescent Walk, Decatur, GA 30033. The current status is inactive.
Licensee Name | TARAYN A FAIRLIE |
Credential ID | 912564 |
Credential Number | 1.048460 |
Credential Type | Physician/Surgeon |
Business Address |
1476 Crescent Walk Decatur GA 30033 |
Business Type | INDIVIDUAL |
Status | INACTIVE - LAPSED DUE TO NON-RENEWAL |
Issue Date | 2010-02-11 |
Effective Date | 2011-07-01 |
Expiration Date | 2012-06-30 |
Refresh Date | 2012-10-05 |
ID | Credential Code | Credential Type | Issue | Term | Status |
---|---|---|---|---|---|
450656 | CSP.0040641 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 2006-12-13 | 2007-03-13 - 2008-02-29 | INACTIVE |
Street Address | 1476 Crescent Walk |
City | Decatur |
State | GA |
Zip Code | 30033 |
Licensee Name | Office Address | Credential | Effective / Expiration |
---|---|---|---|
Ahmed M. Abdel-raouf | 2178 North Decatur Road, Decatur, GA 30033 | Physician/surgeon | 2020-09-01 ~ 2021-08-31 |
Rebecca R Nelson | 2251 Creek Park Road, Decatur, GA 30033 | Registered Nurse | 2020-04-01 ~ 2021-03-31 |
Elizabeth Cutter | 2823 Ponderosa Circle, Decatur, GA 30033 | Marital and Family Therapist | 2019-12-01 ~ 2020-11-30 |
Mary R Nugent | 1189 Mayfield Drive, Decatur, GA 30033 | Registered Nurse | 2017-06-01 ~ 2018-05-31 |
Paul A Carlson | 1908 Ludovie Lane, Decatur, GA 30033 | Professional Engineer | 2014-02-01 ~ 2015-01-31 |
William A Bennett Jr · Heery Architects & Engr Inc | 2276 Fair Oaks Rd, Decatur, GA 30033 | Professional Engineer | 1990-02-06 ~ 1991-01-31 |
Scott Alan Davis | 647 Park Lane, Decatur, GA 30033 | Professional Engineer | 2004-02-01 ~ 2005-01-31 |
Georgia Innocence Project Inc | 2645 North Decatur Road, Decatur, GA 30033 | Public Charity | 2010-12-01 ~ 2011-11-30 |
Chester Mcdonnell | 601 Tuxworth Circle, Decatur, GA 30033 | Registered Nurse | 2008-05-02 ~ 2009-06-30 |
Louise J Short | 2520 Oak Crossing, Decatur, GA 30033 | Physician/surgeon | 1992-10-23 ~ 1993-06-30 |
Find all Licenses in zip 30033 |
City | Decatur |
Zip Code | 30033 |
License Type | Physician/Surgeon |
License Type + County | Physician/Surgeon + Decatur |
Licensee Name | Office Address | Credential | Effective / Expiration |
---|---|---|---|
James R Henderson | 90 Fairlie St Nw Apt 303, Atlanta, GA 30303 | Professional Engineer | 2015-02-01 ~ 2016-01-31 |
Erika B Fairlie | 9 Rolling Green Dr, Granby, CT 06035-1911 | Architect | 2019-08-01 ~ 2020-07-31 |
Jenna R Fairlie | 68 Winterberry Lane, Florence, MA 01062 | Registered Nurse | 2011-01-01 ~ 2011-12-31 |
Alistar Fairlie | 4 Woodland Ridge Rd, Southwick, MA 01077 | Electrical Limited Journeyperson | 2019-10-01 ~ 2020-09-30 |
David A Fairlie | 1513 Pangborn Station Dr, Decatur, GA 30033-1845 | Engineer-in-training | 2011-02-15 ~ 2021-02-15 |
Chester W Fairlie | 14 Green Valley Lake Road, East Lyme, CT 06333 | Emergency Medical Technician | ~ 1995-04-01 |
Penny Lamhut Md | Genesis Physician Services, Windsor, CT 06098 | Physician/surgeon | 1999-07-15 ~ 2000-07-31 |
Gilbert L Drozdow | Envision Physician Services, Plantation, FL 33322 | Physician/surgeon | 2019-10-01 ~ 2020-09-30 |
Russell H Harris Md | Envision Physician Services, Horsham, PA 19044 | Physician/surgeon | 2019-09-01 ~ 2020-08-31 |
John T Thompson | Physician Pavilion W, Towson, MD 21204 | Physician/surgeon | 2020-07-01 ~ 2021-06-30 |
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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).