CARL C BLACKWOOD (Credential# 1136622) is licensed (Advanced Practice Registered Nurse) with Connecticut Department of Consumer Protection. The license effective date is May 1, 2020. The license expiration date date is April 30, 2021. The license status is ACTIVE.
CARL C BLACKWOOD is licensed with the Department of Consumer Protection of Connecticut. The credential number is #12.005251. The credential type is advanced practice registered nurse. The effective date is May 1, 2020. The expiration date is April 30, 2021. The business address is 5613 Hampshire Lane, Ypsilanti, MI 48197. The current status is active.
| Licensee Name | CARL C BLACKWOOD |
| Credential ID | 1136622 |
| Credential Number | 12.005251 |
| Credential Type | Advanced Practice Registered Nurse |
| Business Address |
5613 Hampshire Lane Ypsilanti MI 48197 |
| Business Type | INDIVIDUAL |
| Status | ACTIVE - CURRENT |
| Active | 1 |
| Issue Date | 2012-12-18 |
| Effective Date | 2020-05-01 |
| Expiration Date | 2021-04-30 |
| Refresh Date | 2020-03-27 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 1136620 | 10.109411 | Registered Nurse | 2012-12-18 | 2020-05-01 - 2021-04-30 | ACTIVE |
| 1136908 | 10.109371-TEMP | Registered Nurse - Temporary | 2012-12-13 | 2012-12-13 - 2013-04-12 | INACTIVE |
| Street Address | 5613 HAMPSHIRE LANE |
| City | YPSILANTI |
| State | MI |
| Zip Code | 48197 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Nader Roy Mohtadi | 5333 Mcauley Dr., Ypsilanti, MI 48197 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Alyssa K Copeland | 8808 Amaranth Lane, Ypsilanti, MI 48197 | Registered Nurse | 2020-02-01 ~ 2021-01-31 |
| Marcie M Moore | 200 W Michigan Ave, Ypsilanti, MI 48197 | Registered Nurse | 2016-04-01 ~ 2017-03-31 |
| Ave Maria College of The Americas | 300 W Forest Ave., Ypsilanti, MI 48197 | Public Charity-exempt From Financial Requirements | ~ |
| Eastern Michigan University Foundation | 1349 S. Huron Street, Ypsilanti, MI 48197 | Public Charity-exempt From Financial Requirements | ~ |
| Opal C Williams | 4125 Hawks Cove, Ann Arbor, MI 48197 | Registered Nurse | 2004-07-12 ~ 2005-08-31 |
| Noreen Taylor | P.o. Box 972271, Ypsilanti, MI 48197 | Licensed Practical Nurse | 1984-05-30 ~ 1991-08-31 |
| Regina M Crincoli | 4855 Lakeridge St, Ypsilanti, MI 48197 | Registered Nurse | 2006-05-25 ~ 2007-07-31 |
| Douglas J Holcomb | 1455 Roosevelt, Ypsilanti, MI 48197 | Electrical Unlimited Journeyperson | ~ |
| Donald R Stout | 461 Brookside Rd, Ypsilanti, MI 48197 | Electrical Unlimited Journeyperson | ~ |
| Find all Licenses in zip 48197 | |||
| City | YPSILANTI |
| Zip Code | 48197 |
| License Type | Advanced Practice Registered Nurse |
| License Type + County | Advanced Practice Registered Nurse + YPSILANTI |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Hope Larose | 86 La Costa Dr, Blackwood, NJ 08012-5536 | Advanced Practice Registered Nurse | 2020-05-01 ~ 2021-04-30 |
| Carl Bordas | 1025 Golden Grove Drive, The Villages, FL 32162-4022 | Advanced Practice Registered Nurse | 2012-02-01 ~ 2013-01-31 |
| Kim E Cotnoir | Po Box 656, Johnson, VT 05656-0656 | Advanced Practice Registered Nurse | 2020-08-01 ~ 2021-07-31 |
| L. Ann Whitaker | 20 Sconset Ln, Guilford, CT 06437-1899 | Advanced Practice Registered Nurse | 2017-11-01 ~ 2018-10-31 |
| Gordon P Kempe | Po Box 277, Sanbornton, NH 03269 | Advanced Practice Registered Nurse | 2004-04-22 ~ 2005-06-30 |
| Joanna Mrozek | 270 Oak St, Manchester, CT 06040-5563 | Advanced Practice Registered Nurse | 2020-05-01 ~ 2021-04-30 |
| Elizabeth S Doty | 77 Lee Dr, Southington, CT 06489-2926 | Advanced Practice Registered Nurse | 2020-06-01 ~ 2021-05-31 |
| Ricky G Ewell II | 177 9th Ave Apt 5d, New York, NY 10011-4974 | Advanced Practice Registered Nurse | 2020-05-01 ~ 2021-04-30 |
| Maryann B Roik | Po Box 157, Holmdel, NJ 07733-0157 | Advanced Practice Registered Nurse | 2018-06-01 ~ 2019-05-31 |
| Kelsey N.m. Adams | 105 E St Ste 2b, Davis, CA 95616-4567 | Advanced Practice Registered Nurse | 2013-07-01 ~ 2014-06-30 |
Please comment or provide details below to improve the information on CARL C BLACKWOOD.
| 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).