HOLLY BLACKBURN (Credential# 1491524) is licensed (Resident Physician) with Connecticut Department of Consumer Protection. The license effective date is July 1, 2020. The license expiration date date is June 30, 2021. The license status is ACTIVE.
HOLLY BLACKBURN is licensed with the Department of Consumer Protection of Connecticut. The credential number is #1.059259-RES. The credential type is resident physician. The effective date is July 1, 2020. The expiration date is June 30, 2021. The business address is 205 Church Street, New Haven, CT 06510. The current status is active.
| Licensee Name | HOLLY BLACKBURN |
| Credential ID | 1491524 |
| Credential Number | 1.059259-RES |
| Credential Type | Resident Physician |
| Credential SubCategory | RES |
| Business Address |
205 Church Street New Haven CT 06510 |
| Business Type | INDIVIDUAL |
| Status | ACTIVE - CURRENT |
| Active | 1 |
| Issue Date | 2017-06-13 |
| Effective Date | 2020-07-01 |
| Expiration Date | 2021-06-30 |
| Refresh Date | 2020-06-04 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 1431273 | CSP.0065891 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 2017-06-15 | 2019-03-01 - 2021-02-28 | ACTIVE |
| Street Address | 205 Church Street |
| City | New Haven |
| State | CT |
| Zip Code | 06510 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Mikheil Verulashvili | 205 Church Street, New Haven, CT 06510 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Tyler Cooper & Alcorn Foundation Inc. | 205 Church Street, New Haven, CT 06510 | Public Charity | 2008-06-01 ~ 2009-05-31 |
| Ely Becker | 205 Church Street, New Haven, CT 06509 | Certified Public Accountant Firm Permit | 1987-12-08 ~ 1987-12-31 |
| William B Gumbart | 205 Church Street, New Haven, CT 06500 | Notary Public Appointment | 1979-02-01 ~ 1984-03-31 |
| Mary Passell | 205 Church Street, New Haven, CT 06500 | Notary Public Appointment | 1979-10-01 ~ 1984-03-31 |
| Leonard J Gilhuly | 205 Church Street, New Haven, CT 06500 | Notary Public Appointment | 1976-04-01 ~ 1981-03-31 |
| Morris W Mendleshn | 205 Church Street, New Haven, CT 06500 | Notary Public Appointment | 1976-05-01 ~ 1981-03-31 |
| John H Weir | 205 Church Street, New Haven, CT 06500 | Notary Public Appointment | 1976-07-01 ~ 1981-03-31 |
| Richard F Lawler | 205 Church Street, New Haven, CT 06500 | Notary Public Appointment | 1974-06-17 ~ 1979-03-31 |
| Albert W Sheppard | 205 Church Street, New Haven, CT 06500 | Notary Public Appointment | 1973-02-01 ~ 1978-03-31 |
| Find all Licenses in the same address | |||
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Gary P Bernardi Jr | Yale New Haven Hospital, New Haven, CT 06510 | Advanced Practice Registered Nurse | 2020-07-01 ~ 2021-06-30 |
| Katherine G Kennedy | 65 Trumbull St, New Haven, CT 06510 | Physician/surgeon | 2020-07-01 ~ 2021-06-30 |
| Molly Elizabeth Mcadow | 333 Cedar Street, New Haven, CT 06510 | Physician/surgeon | 2020-07-01 ~ 2021-06-30 |
| Brady Dunkle | 58 Vernon Street, New Haven, CT 06510 | Registered Nurse | ~ |
| Karin Ann Price | 20 York St, New Haven, Ct 06510, New Haven, CT 06510 | Registered Nurse - Temporary | 2020-06-25 ~ 2020-10-23 |
| G C S Constuction LLC | 142 Temple Street, New Haven, CT 06510 | Major Contractor | 2020-07-01 ~ 2021-06-30 |
| Paul L Mccarthy Md · Yale School of Medicine | Dept of Pediatrics, New Haven, CT 06510 | Physician/surgeon | 2020-09-01 ~ 2021-08-31 |
| Lauren E Cohn Md | Yale New-haven Hospital, New Haven, CT 06510 | Physician/surgeon | 2020-07-01 ~ 2021-06-30 |
| Bong Francois | 900 Chapel St Apt 901, New Haven, CT 06510 | Combination Nail Technician, Esthetician Or Eyelash Technici | ~ |
| Pelli Clarke Pelli Architects Inc. | 1056 Chapel St, New Haven, CT 06510 | Architecture Corporation | 2020-08-01 ~ 2021-07-31 |
| Find all Licenses in zip 06510 | |||
| City | New Haven |
| Zip Code | 06510 |
| License Type | Resident Physician |
| License Type + County | Resident Physician + New Haven |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| John A Blackburn | Blackburn Architects, Washington, DC 20036 | Architect | 2019-08-01 ~ 2020-07-31 |
| Paul Blackburn · Blackburn Carpentry Services | 167 West Granby Rd, Granby, CT 06035 | Home Improvement Contractor | 2019-12-01 ~ 2020-11-30 |
| Roy M Blackburn | 803 N. Dixie Ave, Ste 234, Elizabethtown, KY 42701 | Physician/surgeon | 2002-08-27 ~ 2003-08-31 |
| Christina G Aranda | 15 Blackburn Ct., New Hartford, NY 13413 | Physician/surgeon | 2009-04-15 ~ 2009-09-30 |
| Bradley A Blackburn | 200 California Rd Apt 21, Bronxville, NY 10708-4427 | Physician/surgeon | 1985-07-12 ~ 1987-04-30 |
| Eric Davis | 3000 Blackburn, Dallas, TX 75204 | Physician/surgeon | 2007-09-11 ~ 2008-08-31 |
| Blackburn Enterprises LLC · Pietra Santa Winery | 10034 Cienega Rd, Hollister, CA 95023-9617 | Out of State Winery | 2016-02-27 ~ 2017-02-26 |
| Blackburn 609 Paso Robles | Connecticut Brand Registration, Hartford, CT 06106 | Liquor Brand Label | 2006-03-21 ~ 2009-03-20 |
| Blackburn Pinot Noir | Connecticut Brand Registration, Hartford, CT 06106 | Liquor Brand Label | 2011-07-07 ~ 2014-07-06 |
| Blackburn Merlot Paso Robles | Connecticut Brand Registration, Hartford, CT 06106 | Liquor Brand Label | 2011-09-30 ~ 2014-09-28 |
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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).