BEN FREIBERG (Credential# 1490689) is licensed (Resident Physician) with Connecticut Department of Consumer Protection. The license effective date is July 1, 2017. The license expiration date date is June 30, 2021. The license status is ACTIVE.
BEN FREIBERG is licensed with the Department of Consumer Protection of Connecticut. The credential number is #1.058791-RES. The credential type is resident physician. The effective date is July 1, 2017. The expiration date is June 30, 2021. The business address is 352 Lagrange St., West Roxbury, MA 02132. The current status is active.
| Licensee Name | BEN FREIBERG |
| Credential ID | 1490689 |
| Credential Number | 1.058791-RES |
| Credential Type | Resident Physician |
| Credential SubCategory | RES |
| Business Address |
352 Lagrange St. West Roxbury MA 02132 |
| Business Type | INDIVIDUAL |
| Status | ACTIVE - CURRENT |
| Active | 1 |
| Issue Date | 2017-07-01 |
| Effective Date | 2017-07-01 |
| Expiration Date | 2021-06-30 |
| Refresh Date | 2020-05-27 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 1435638 | CSP.0066161 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 2017-07-07 | 2019-03-01 - 2021-02-28 | ACTIVE |
| 1399169 | 1.056163 | Physician/Surgeon | 2017-02-23 | 2019-12-01 - 2020-11-30 | ACTIVE |
| Street Address | 352 LaGrange St. |
| City | West Roxbury |
| State | MA |
| Zip Code | 02132 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Kathryn Boyne | 10 Graham Ter, West Roxbury, MA 02132 | Licensed Clinical Social Worker | ~ |
| James Pappas | 264 Temple St, West Roxbury, MA 02132 | Real Estate Broker | 2019-04-01 ~ 2020-03-31 |
| Mary N Tenenbaum | 282 Perham St, Boston, MA 02132 | Physician/surgeon | 2020-04-01 ~ 2021-03-31 |
| Kate Larsen | 15 Lorette Street, Boston, MA 02132 | Certified Public Accountant License | 2019-01-01 ~ 2019-12-31 |
| Jacob Williams | 16 Bobolink St, West Roxbury, MA 02132 | Professional Counselor Associate | 2020-01-21 ~ 2020-11-30 |
| Michelle A Celentano | 8 Glenburnie Rd, West Roxbury, MA 02132 | Pharmacist | 2020-02-01 ~ 2022-01-31 |
| Ruth C Peterle-dzurec | 506 Lagrange Street, West Roxbury, MA 02132 | Registered Nurse | 2019-12-01 ~ 2020-11-30 |
| Bridgid Maeve O'brien | 665 West Roxbury Pkwy, West Roxbury, MA 02132 | Registered Nurse | 2019-08-01 ~ 2020-07-31 |
| Guixiao Li | 29 Maplewood Street, West Roxbury, MA 02132 | Certified Public Accountant License | 2020-01-01 ~ 2020-12-31 |
| Michael A Severo | 92 Corey Street, West Roxbury, MA 02132 | Physical Therapist | 2019-09-01 ~ 2020-08-31 |
| Find all Licenses in zip 02132 | |||
| City | West Roxbury |
| Zip Code | 02132 |
| License Type | Resident Physician |
| License Type + County | Resident Physician + West Roxbury |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Coturri Zinfandel Freiberg | Connecticut Brand Registration, Hartford, CT 06106 | Liquor Brand Label | 2007-03-28 ~ 2010-03-27 |
| Hofer Gruner Veltliner Freiberg | Connecticut Brand Registration, Hartford, CT 06106 | Liquor Brand Label | 2008-11-26 ~ 2011-04-23 |
| Sarah Ct Freiberg | 134 State St, Meriden, CT 06450-3293 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Craig S Freiberg | 157 Leeder Hill Dr Unit 603, Hamden, CT 06517 | Controlled Substance Registration for Practitioner | 2004-10-04 ~ 2005-02-28 |
| Gin Yi Lee | 24 Hospital Ave, Danbury, CT 06810-6099 | Resident Physician | 2019-06-20 ~ 2022-06-30 |
| Tao Zuo | 20 York St., New Haven, CT 06510-3220 | Resident Physician | 2016-07-25 ~ 2020-06-30 |
| Victoria Parker | CT | Resident Physician | 2015-06-23 ~ 2021-06-30 |
| Jin Woo Yoo | 44 Orange St Apt 317, New Haven, CT 06510 | Resident Physician | 2020-07-01 ~ 2021-06-30 |
| Jia Wei Tan | 267 Grant St, Bridgeport, CT 06610-2805 | Resident Physician | 2020-06-22 ~ 2023-06-30 |
| Yan Zhu | 27 Brainerd Rd # B, Branford, CT 06405-6302 | Resident Physician | 2020-07-01 ~ 2021-06-30 |
Please comment or provide details below to improve the information on BEN FREIBERG.
| 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).