DONALD R BLACK MD (Credential# 976031) is licensed (Controlled Substance Registration for Practitioner) with Connecticut Department of Consumer Protection. The license effective date is March 1, 2011. The license expiration date date is February 28, 2013. The license status is INACTIVE.
DONALD R BLACK MD is licensed with the Department of Consumer Protection of Connecticut. The credential number is #CSP.0049390. The credential type is controlled substance registration for practitioner. The effective date is March 1, 2011. The expiration date is February 28, 2013. The business address is 3618 Pinetree Ave Sw, Concord, NC 28027-2712. The current status is inactive.
| Licensee Name | DONALD R BLACK MD |
| Credential ID | 976031 |
| Credential Number | CSP.0049390 |
| Credential Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| Business Address |
3618 Pinetree Ave Sw Concord NC 28027-2712 |
| Business Type | INDIVIDUAL |
| Status | INACTIVE |
| Issue Date | 2010-11-30 |
| Effective Date | 2011-03-01 |
| Expiration Date | 2013-02-28 |
| Refresh Date | 2014-01-29 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 973488 | 1.049354 | Physician/Surgeon | 2010-11-22 | 2011-06-01 - 2012-05-31 | INACTIVE |
| Street Address | 3618 PINETREE AVE SW |
| City | CONCORD |
| State | NC |
| Zip Code | 28027-2712 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Odelia Dawn Harrel | 1422 12th Fairway Drive Nw, Concord, NC 28027 | Registered Nurse - Temporary | 2020-02-20 ~ 2020-06-19 |
| Stacey O Smith | 518 Blue Sky Dr., Concord, NC 28027 | Registered Nurse | 2020-04-01 ~ 2021-03-31 |
| Anne-louise Krug | 3880 Meadow Ridge Drive, Concord, NC 28027 | Registered Nurse | 2020-06-01 ~ 2021-05-31 |
| Shrujal H Shah | 5393 Hackberry Lane Sw, Concord, NC 28027 | Pharmacist | 2020-02-01 ~ 2022-01-31 |
| Robin Lynn Harward | 9438 Coast Laurel Ave Nw, Concord, NC 28027 | Registered Nurse | 2020-01-01 ~ 2020-12-31 |
| Kerry A Abate | 1465 Duckhorn St Nw, Concord, NC 28027 | Registered Nurse | 2019-11-01 ~ 2020-10-31 |
| Keilin Ortega | 3916 Summerhill Court Nw, Concord, NC 28027 | Electrical Unlimited Journeyperson | 2018-10-01 ~ 2019-09-30 |
| David S Green | 349 Canter Court Nw, Concord, NC 28027 | Electrical Unlimited Journeyperson | 2019-10-01 ~ 2020-09-30 |
| Julie Anne Holder | 9688 Marquette St. Nw, Concord, NC 28027 | Registered Nurse | 2019-11-01 ~ 2020-10-31 |
| Leeann Bronner | 1050 Stirrup Pl Nw, Concord, NC 28027 | Tax Preparer/facilitator Permit | 2018-12-13 ~ 2020-12-31 |
| Find all Licenses in zip 28027 | |||
| City | CONCORD |
| Zip Code | 28027 |
| License Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| License Type + County | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER + CONCORD |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| William Harless | 100 Black Rock Lighthouse Road, Black Rock, NS B1X 2A3 | Controlled Substance Registration for Practitioner | 2019-05-07 ~ 2021-02-28 |
| Eleanore K Black | 38 Volunteer Ln Apt 4, Greenwich, CT 06830-5414 | Controlled Substance Registration for Practitioner | 2020-06-04 ~ 2021-02-28 |
| Eric W Black | 365 Mather St Apt 197, Hamden, CT 06514-3151 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Jonathan D Black | 120 Knollwood Dr, New Haven, CT 06515-2459 | Controlled Substance Registration for Practitioner | 2017-03-01 ~ 2019-02-28 |
| Donald T Evans | Po Box 347, Newtown, CT 06470 | Controlled Substance Registration for Practitioner | 2007-03-01 ~ 2008-02-29 |
| Donald Dib | 839 River Rd # A, Shelton, CT 06484-5433 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Maridanielle O Annicchiarico | 15 Black Angus Ct, Newburgh, NY 12550-1567 | Controlled Substance Registration for Practitioner | 2015-11-19 ~ 2017-02-28 |
| David L Black | 31 Old Nursery Drive, Wilton, CT 06897 | Controlled Substance Registration for Practitioner | 2013-06-17 ~ 2015-02-28 |
| Maria O Burgin | 267 Old Toll Cir, Black Mountain, NC 28711-9207 | Controlled Substance Registration for Practitioner | 2013-06-06 ~ 2015-02-28 |
| Deborah Black | 2127 Talmage Dr, Leland, NC 28451-9340 | Controlled Substance Registration for Practitioner | 2017-03-01 ~ 2019-02-28 |
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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).