DOUGLAS A BALLAN (Credential# 1333188) is licensed (Physician/surgeon) with Connecticut Department of Consumer Protection. The license effective date is January 1, 2017. The license expiration date date is December 31, 2017. The license status is INACTIVE.
DOUGLAS A BALLAN is licensed with the Department of Consumer Protection of Connecticut. The credential number is #1.055094. The credential type is physician/surgeon. The effective date is January 1, 2017. The expiration date is December 31, 2017. The business address is 145 Connetquot Dr, Oakdale, NY 11769-1902. The current status is inactive.
| Licensee Name | DOUGLAS A BALLAN |
| Credential ID | 1333188 |
| Credential Number | 1.055094 |
| Credential Type | Physician/Surgeon |
| Business Address |
145 Connetquot Dr Oakdale NY 11769-1902 |
| Business Type | INDIVIDUAL |
| Status | INACTIVE - LAPSED DUE TO NON-RENEWAL |
| Issue Date | 2016-03-29 |
| Effective Date | 2017-01-01 |
| Expiration Date | 2017-12-31 |
| Refresh Date | 2018-04-05 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 1342339 | CSP.0062344 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 2016-03-30 | 2016-03-30 - 2017-01-17 | INACTIVE |
| Street Address | 145 CONNETQUOT DR |
| City | OAKDALE |
| State | NY |
| Zip Code | 11769-1902 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| John M Davis | 21princess Gate, Oakdale, NY 11769 | Physician/surgeon | 2020-09-01 ~ 2021-08-31 |
| Modern Italian Bakery of W Babylon | 301 Locust Ave, Oakdale, NY 11769 | Bakery | 2020-07-01 ~ 2021-06-30 |
| Pegasus Dme Inc Dba National Brace · Prothotics Health | 1213a Montauk Hwy, Oakdale, NY 11769 | Wholesaler of Drugs, Cosmetics & Medical Devices | 2018-07-01 ~ 2019-06-30 |
| Palermo Flooring Inc · Hardwood Flooring | 4128 Sunrise Highway, Oakdale, NY 11769 | Home Improvement Contractor | 2019-12-01 ~ 2020-11-30 |
| Susan E. Bodian | 42 Greenview Court, Oakdale, NY 11769 | Registered Nurse | 2019-07-01 ~ 2020-06-30 |
| Christina L Kelly | 4 Vincent Place, Oakdale, NY 11769 | Emergency Medical Technician | 2008-08-28 ~ 2010-04-01 |
| Jamie R Atkinson | 42 Lincoln Drive, Oakdale, NY 11769 | Emergency Medical Technician | 2007-10-03 ~ 2009-07-01 |
| Alyssa L Casalini | 10 Hewlett Lane, Oakdale, NY 11769 | Licensed Practical Nurse | 2008-02-20 ~ 2009-03-31 |
| Daniel B Mazza | 43 Riverdale Avenue, Oakdale, NY 11769 | Lead Abatement Supervisor | ~ 1999-09-30 |
| Thomas J Minutolo | 32-13 Wilshire Ln, Oakdale, NY 11769 | Electrical Unlimited Journeyperson | ~ |
| Find all Licenses in zip 11769 | |||
| City | OAKDALE |
| Zip Code | 11769 |
| License Type | Physician/Surgeon |
| License Type + County | Physician/Surgeon + OAKDALE |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Douglas R. Mailly | 119 Russell St, Cornwall, NY 12518-1711 | Physician/surgeon | ~ |
| Cyle Douglas Rogotzke | 307 S Evergreen Ave, Woodbury, NJ 08096-2739 | Physician/surgeon | ~ |
| Douglas Dechairo | 910 E Ohio Ave Ste 103, Escondido, CA 92025-3439 | Physician/surgeon | 1972-09-20 ~ 1983-02-28 |
| Douglas Kornreich | 36 Washburn Rd, Mount Kisco, NY 10549 | Physician/surgeon | ~ |
| Douglas R Whipple Md | 30 Wildwood Dr, Avon, CT 06001 | Physician/surgeon | 2020-03-01 ~ 2021-02-28 |
| Douglas G Walled | 100 Luquer St, Brooklyn, NY 11231 | Physician/surgeon | 2016-04-01 ~ 2017-03-31 |
| Douglas E Hertford Md | 19 Cattle Pen Ln, Ridgefield, CT 06877-5829 | Physician/surgeon | 2020-02-06 ~ 2020-08-31 |
| Douglas R Porter | 336 22nd Ave N, Nashville, TN 37203-1844 | Physician/surgeon | 2019-10-01 ~ 2020-09-30 |
| Craig A Mcpherson | 614 Douglas Dr, Orange, CT 06477 | Physician/surgeon | 2020-03-01 ~ 2021-02-28 |
| Douglas N. Mintz | 535 E 70th St, New York, NY 10021-4823 | Physician/surgeon | 2019-10-01 ~ 2020-09-30 |
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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).