ZEV BALSEN (Credential# 1286759) is licensed (Controlled Substance Registration for Practitioner) with Connecticut Department of Consumer Protection. The license effective date is March 1, 2019. The license expiration date date is February 28, 2021. The license status is ACTIVE.
ZEV BALSEN is licensed with the Department of Consumer Protection of Connecticut. The credential number is #CSP.0060319. The credential type is controlled substance registration for practitioner. The effective date is March 1, 2019. The expiration date is February 28, 2021. The business address is 267 Grant St, Bridgeport, CT 06610. The current status is active.
| Licensee Name | ZEV BALSEN |
| Credential ID | 1286759 |
| Credential Number | CSP.0060319 |
| Credential Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| Business Address |
267 Grant St Bridgeport CT 06610 |
| Business Type | INDIVIDUAL |
| Status | ACTIVE - CURRENT |
| Active | 1 |
| Issue Date | 2015-06-18 |
| Effective Date | 2019-03-01 |
| Expiration Date | 2021-02-28 |
| Refresh Date | 2018-12-28 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 1502634 | 1.060595 | Physician/Surgeon | 2018-05-07 | 2020-01-01 - 2020-12-31 | ACTIVE |
| 1491503 | 1.059238-RES | Resident Physician | 2017-07-01 | 2018-07-01 - 2019-06-30 | INACTIVE |
| 843480 | 70.003747 | Emergency Medical Technician | 2003-07-17 | 2003-07-17 - 2005-03-31 | INACTIVE |
| Street Address | 267 Grant St |
| City | Bridgeport |
| State | CT |
| Zip Code | 06610 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Lauren Roth | 267 Grant St, Bridgeport, CT 06610-2805 | Resident Physician | 2020-06-22 ~ 2024-06-30 |
| Madeline Carmain | 267 Grant St, Bridgeport, CT 06610-2805 | Resident Physician | 2020-06-22 ~ 2024-06-30 |
| Aishwariya S Vegunta | 267 Grant St, Bridgeport, CT 06610-2805 | Resident Physician | 2020-07-01 ~ 2024-06-30 |
| Rasha T Ismail | 267 Grant St, Bridgeport, CT 06610-2805 | Resident Physician | 2020-07-01 ~ 2024-06-30 |
| Mark Steven Mcfarland | 267 Grant St, Bridgeport, CT 06610-2805 | Resident Physician | 2018-07-01 ~ 2023-06-30 |
| Benjamin Hans Jeuk | 267 Grant St, Bridgeport, CT 06610 | Resident Physician | 2020-06-22 ~ 2023-06-30 |
| Lucia Plichtova | 267 Grant St, Bridgeport, CT 06610-2805 | Resident Physician | 2020-06-22 ~ 2023-06-30 |
| Kwabena Sefah Nketiah Sarpong | 267 Grant St, Bridgeport, CT 06610-2805 | Resident Physician | 2020-06-22 ~ 2023-06-30 |
| Prajna D'silva | 267 Grant St, Bridgeport, CT 06610-2805 | Resident Physician | 2020-06-22 ~ 2023-06-30 |
| Fabricio Malaguez Webber | 267 Grant St, Bridgeport, CT 06610-2805 | Resident Physician | 2020-06-22 ~ 2023-06-30 |
| Find all Licenses in the same address | |||
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Nilca Janice Cardenales | 66 Rose St, Bridgeport, CT 06610 | Combination Nail Technician, Esthetician Or Eyelash Technici | ~ |
| Kiara Lizbeth Corporan | 10 Sturtevant Pl, Bridgeport, CT 06610 | Eyelash Technician | ~ |
| Alisha Garcia | 65 Berkeley Place, Bridgeport, CT 06610 | Notary Public Appointment | 2020-06-26 ~ 2025-06-30 |
| Pauline Parkes | 96 Virginia Avenue, Bridgeport, CT 06610 | Licensed Clinical Social Worker | ~ |
| Denise Reyes | 1125 Huntington Turnpike, Bridgeport, CT 06610 | Registered Nurse | 2020-07-01 ~ 2021-06-30 |
| Avery M Rilley | 80 Granfield Avenue, Bridgeport, CT 06610 | Pharmacy Technician | 2020-06-25 ~ 2021-03-31 |
| Bozena K. Malyszko | Bridgeport Hospital, Bridgeport, CT 06610 | Physician/surgeon | 2020-07-01 ~ 2021-06-30 |
| Amy Espinosa | 146 Court D, Bridgeport, CT 06610 | Notary Public Appointment | 2020-07-01 ~ 2025-06-30 |
| Wilhelmina Jackson · Thomas | 172 Court D, Bridgeport, CT 06610 | Registered Nurse | 2020-08-01 ~ 2021-07-31 |
| Emma Agyeiwaa Vaczek | P.o Box 5223, Bridgeport, CT 06610 | Licensed Practical Nurse | 2020-08-01 ~ 2021-07-31 |
| Find all Licenses in zip 06610 | |||
| City | Bridgeport |
| Zip Code | 06610 |
| License Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| License Type + County | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER + Bridgeport |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Steven Kassels Md · Community Substance Abuse Center | Comm. Physicians PC/125 North Elm Street, Westfield, MA 01085 | Controlled Substance Registration for Practitioner | 2018-06-15 ~ 2019-02-28 |
| Shu-i Lin | CT | Controlled Substance Registration for Practitioner | 2017-06-12 ~ 2019-02-28 |
| Arundati Rao | CT | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Huu Duc D Luu | 630 Mix Ave Apt 6p, Hamden, CT 06514-2320 | Controlled Substance Registration for Practitioner | 2011-03-01 ~ 2013-02-28 |
| Min Jin Kim | 639 4th Ave Apt 5c, Brooklyn, NY 11232-1048 | Controlled Substance Registration for Practitioner | 2012-05-10 ~ 2013-02-28 |
| Qi Che Md | Bridgeport, CT 06610 | Controlled Substance Registration for Practitioner | 2006-03-01 ~ 2007-02-28 |
| Erin K Fee | CT | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Hae J Kim Pa | New Haven, CT 06511 | Controlled Substance Registration for Practitioner | 2008-03-31 ~ 2009-02-28 |
| Yi An | 20 York St, New Haven, CT 06510-3220 | Controlled Substance Registration for Practitioner | 2017-03-01 ~ 2019-02-28 |
| Shu Pan | 360 State St Apt 702, New Haven, CT 06510-3602 | 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).