ERIC WYDRA (Credential# 1491055) is licensed (Resident Physician) with Connecticut Department of Consumer Protection. The license effective date is June 25, 2015. The license expiration date date is June 30, 2018. The license status is INACTIVE.
ERIC WYDRA is licensed with the Department of Consumer Protection of Connecticut. The credential number is #1.059157-RES. The credential type is resident physician. The effective date is June 25, 2015. The expiration date is June 30, 2018. The business address is 151 Ardmore Ave, Haddonfield, NJ 08033-1427. The current status is inactive.
| Licensee Name | ERIC WYDRA |
| Credential ID | 1491055 |
| Credential Number | 1.059157-RES |
| Credential Type | Resident Physician |
| Credential SubCategory | RES |
| Business Address |
151 Ardmore Ave Haddonfield NJ 08033-1427 |
| Business Type | INDIVIDUAL |
| Status | INACTIVE - INACTIVE |
| Issue Date | 2015-06-25 |
| Effective Date | 2015-06-25 |
| Expiration Date | 2018-06-30 |
| Refresh Date | 2018-07-01 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 1281486 | CSP.0059944 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 2015-07-14 | 2015-07-14 - 2017-02-28 | INACTIVE |
| Street Address | 151 ARDMORE AVE |
| City | HADDONFIELD |
| State | NJ |
| Zip Code | 08033-1427 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Jana Goldberg | 156 W. 56th Street, New York, NY 08033 | Physician/surgeon | ~ |
| Brian J Connolly Jr | 23 Estaugh Ave, Haddonfield, NJ 08033 | Pharmacist | 2019-12-20 ~ 2022-01-31 |
| Frank Dellorco | 419 Washington Ave, Haddonfield, NJ 08033 | Certified Public Accountant Certificate | 2020-01-01 ~ 2020-12-31 |
| John W Kornick | 3 Manor Lane, Haddonfield, NJ 08033 | Professional Engineer | ~ |
| Gary S Narducci | 333 Farwwod Rd, Haddonfield, NJ 08033 | Real Estate Salesperson | 2009-06-01 ~ 2010-05-31 |
| Steven J Mcclane Md | 3 Cooper Plaza, Suite 411, Camden, NJ 08033 | Controlled Substance Registration for Practitioner | 2013-03-01 ~ 2015-02-28 |
| Cheryl L Davis Md | 201 Merion Ave, Haddonfield, NJ 08033 | Physician/surgeon | 2012-04-01 ~ 2013-03-31 |
| Julie Natale Fenton | 128 Gill Road, Haddonfield, NJ 08033 | Certified Public Accountant License | 2008-01-01 ~ 2008-12-31 |
| Judith F Rowland | 611 Avondale Ave, Haddonfield, NJ 08033 | Physical Therapist | 2009-02-19 ~ 2010-04-30 |
| Grace M Wesolow | 210 W Crystal Lake, Haddonfield, NJ 08033 | Physician/surgeon | 1997-07-02 ~ 1998-07-31 |
| Find all Licenses in zip 08033 | |||
| City | HADDONFIELD |
| Zip Code | 08033 |
| License Type | Resident Physician |
| License Type + County | Resident Physician + HADDONFIELD |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Eric Chang | 15 York St, New Haven, CT 06510-3221 | Resident Physician | 2016-06-27 ~ 2020-06-30 |
| Eric H Grover | 201 Portier Ct E Apt D, Mobile, AL 36607-2255 | Resident Physician | 2014-06-25 ~ 2020-06-30 |
| Eric A Marten | 20 York St, New Haven, CT 06510 | Resident Physician | 2020-06-24 ~ 2021-06-30 |
| Eric Chang | 20 York Street, New Haven, CT 06510-3220 | Resident Physician | 2020-07-01 ~ 2021-06-30 |
| Eric David Strand | 78 Olive St Apt 417, New Haven, CT 06511-6987 | Resident Physician | 2020-07-01 ~ 2021-06-30 |
| Eric Qi-khang Chow | 20 York St, New Haven, CT 06510 | Resident Physician | 2019-07-05 ~ 2021-06-30 |
| Eric D. Silverman | 20 York Street, New Haven, CT 06450 | Resident Physician | 2020-07-01 ~ 2021-06-30 |
| Eric Matthew Gershon | 20 York St, New Haven, CT 06510-3220 | Resident Physician | 2020-07-01 ~ 2021-06-30 |
| Eric Isaac Elliott | 111 Park St Apt 6a, New Haven, CT 06511-5453 | Resident Physician | 2020-07-01 ~ 2021-06-30 |
| Eric Jason Berkowitz | 20 York St., New Haven, CT 06510-3220 | Resident Physician | 2016-06-27 ~ 2019-06-30 |
Please comment or provide details below to improve the information on ERIC WYDRA.
| 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).