LIRAN BLUM (Credential# 1266351) is licensed (Physician/surgeon) with Connecticut Department of Consumer Protection. The license effective date is June 1, 2020. The license expiration date date is May 31, 2021. The license status is ACTIVE.
LIRAN BLUM is licensed with the Department of Consumer Protection of Connecticut. The credential number is #1.054176. The credential type is physician/surgeon. The effective date is June 1, 2020. The expiration date is May 31, 2021. The business address is 15 Riverside Ave, Bristol, CT 06010-6951. The current status is active.
| Licensee Name | LIRAN BLUM |
| Credential ID | 1266351 |
| Credential Number | 1.054176 |
| Credential Type | Physician/Surgeon |
| Business Address |
15 Riverside Ave Bristol CT 06010-6951 |
| Business Type | INDIVIDUAL |
| Status | ACTIVE - CURRENT |
| Active | 1 |
| Issue Date | 2015-05-29 |
| Effective Date | 2020-06-01 |
| Expiration Date | 2021-05-31 |
| Refresh Date | 2020-03-02 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 1289489 | CSP.0060489 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 2015-06-06 | 2019-03-01 - 2021-02-28 | ACTIVE |
| Street Address | 15 Riverside Ave |
| City | BRISTOL |
| State | CT |
| Zip Code | 06010-6951 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Mark D Watson Md | 15 Riverside Ave, Bristol, CT 06010 | Physician/surgeon | 2020-07-01 ~ 2021-06-30 |
| Cara Pittari | 15 Riverside Ave, Bristol, CT 06010 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Alexandra R Vitale | 15 Riverside Ave, Bristol, CT 06010-5161 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Joseph E Marakovits | 22 Pine St Ste 304, Bristol, CT 06010-6951 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Fawad A Kazi Md | 15 Riverside Avenue, Bristol, CT 06010-6951 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Joseph E Marakovits | 15 Riverside Avenue, Bristol, CT 06010-6951 | Physician/surgeon | 2019-10-01 ~ 2020-09-30 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Deborah M Dube · Adamaitis | 33 Peck Lane, Bristol, CT 06010 | Licensed Practical Nurse | 2020-07-01 ~ 2021-06-30 |
| Barbara M Williams | 45 Harrison Street, Bristol, CT 06010 | Notary Public Appointment | 2020-08-01 ~ 2025-07-31 |
| Le Bao Linh Nguyen | 229 Silo Rd, Bristol, CT 06010 | Nail Technician | ~ |
| Tara M Chipman | 38 Grove St, Bristol, CT 06010 | Licensed Practical Nurse | 2020-07-01 ~ 2021-06-30 |
| Jaclyn J Brandolini | 424 Emmett St, Bristol, CT 06010 | Registered Nurse | 2020-07-01 ~ 2021-06-30 |
| Hoa Le | 63 Seminary St, Bristol, CT 06010 | Nail Technician | ~ |
| Barbara E Trench | 25 Peacedale St, Bristol, CT 06010 | Hairdresser/cosmetician | 2020-07-01 ~ 2022-06-30 |
| Tisha A Balfour | 379 West Street, Bristol, CT 06010 | Licensed Practical Nurse | 2020-08-01 ~ 2021-07-31 |
| Meredith Rose Martineau | 15 Bishop Street, Bristol, CT 06010 | Master's Level Social Worker - Temporary Permit | 2020-06-26 ~ 2020-09-06 |
| Jaime L Krueger | 130 Garfield Road, Bristol, CT 06010 | Notary Public Appointment | 2020-06-26 ~ 2025-06-30 |
| Find all Licenses in zip 06010 | |||
| City | BRISTOL |
| Zip Code | 06010 |
| License Type | Physician/Surgeon |
| License Type + County | Physician/Surgeon + BRISTOL |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Michael S. Blum | 84 Hoyt Ln, Guilford, CT 06437-4329 | Physician/surgeon | 2003-02-10 ~ 2004-03-31 |
| Thomas M Blum | 93 Library St., Mystic, CT 06355 | Physician/surgeon | 2020-05-01 ~ 2021-04-30 |
| Susan S Blum Md | 34 Rye Ridge Plaza, Rye Brook, NY 10573 | Physician/surgeon | 2020-07-01 ~ 2021-06-30 |
| Lawrence M Blum Md | 125 Field Point Dr, Fairfield, CT 06824-6374 | Physician/surgeon | 2004-03-09 ~ 2005-04-30 |
| Richard S Blum | 38 Forest Glen Dr, Woodbridge, CT 06525-1449 | Physician/surgeon | 2020-03-01 ~ 2021-02-28 |
| Leslie F Blum | 32 Chestnut Ridge Rd, Armonk, NY 10504 | Physician/surgeon | 2020-02-01 ~ 2021-01-31 |
| Michael Lloyd Blum | 7161 Via Firenze, Boca Raton, FL 33433 | Physician/surgeon | 2020-06-01 ~ 2021-05-31 |
| Irving M. Blum, Cpa | 25 Third Street, Stamford, CT 06905 | Certified Public Accountant Firm Permit | 2003-01-01 ~ 2003-12-31 |
| Joanne Blum-carnevale · Blum-carnevale | 27 Teneycke Hill Rd, N Falmouth, MA 22556 | Advanced Practice Registered Nurse | 2003-01-15 ~ 2004-03-31 |
| Lgc & D, Blum Shapiro, LLC | 29 South Main St., West Hartford, CT 06127 | Certified Public Accountant Firm Permit | 2001-01-01 ~ 2001-12-31 |
Please comment or provide details below to improve the information on LIRAN BLUM.
| 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).