THEODORE J BLUM MD (Credential# 151761) 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.
THEODORE J BLUM MD is licensed with the Department of Consumer Protection of Connecticut. The credential number is #CSP.0003870. 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 5 School St, Bethel, CT 06801. The current status is active.
| Licensee Name | THEODORE J BLUM MD |
| Credential ID | 151761 |
| Credential Number | CSP.0003870 |
| Credential Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| Business Address |
5 School St Bethel CT 06801 |
| Business Type | INDIVIDUAL |
| Status | ACTIVE - CURRENT |
| Active | 1 |
| Issue Date | 1999-03-01 |
| Effective Date | 2019-03-01 |
| Expiration Date | 2021-02-28 |
| Refresh Date | 2018-12-28 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 543336 | 1.020482 | Physician/Surgeon | 1978-05-31 | 2019-12-01 - 2020-11-30 | ACTIVE |
| 346437 | CSP.0033912 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 2009-03-01 - 2011-02-28 | INACTIVE | |
| 155582 | CSP.0013604 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 1993-08-16 - 1995-07-01 | INACTIVE |
| Street Address | 5 SCHOOL ST |
| City | BETHEL |
| State | CT |
| Zip Code | 06801 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Peter A Link | 5 School St, Bethel, CT 06801-1854 | Optometrist | 2020-06-01 ~ 2021-05-31 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| John Anthony Dulko | 6 Winthrop Road, Bethel, CT 06801 | Notary Public Appointment | 2020-06-26 ~ 2025-06-30 |
| Antonietta Sproviero-metaxas | 36 Quaker Ridge Road, Bethel, CT 06801 | Hairdresser/cosmetician | 2020-07-01 ~ 2022-06-30 |
| Mark K Roos | 6 Crestview Road, Bethel, CT 06801 | Licensed Clinical Social Worker | 2020-07-01 ~ 2021-06-30 |
| Susan Nguyen | 14b Cawley Ave., Bethel, CT 06801 | Esthetician | ~ |
| Blue Jay Orchards | 125 Plumtrees Rd, Bethel, CT 06801 | Operator of Weighing & Measuring Devices | 2020-08-01 ~ 2021-07-31 |
| Varano Bakery | 198 Greenwood Ave, Bethel, CT 06801 | Operator of Weighing & Measuring Devices | 2020-08-01 ~ 2021-07-31 |
| Nina M Kilcourse | 3 Bayberry Hill Rd, Bethel, CT 06801 | Hairdresser/cosmetician | 2020-09-01 ~ 2022-08-31 |
| Ralph Ramsdell · Big Y | 83 Stony Hill Road, Bethel, CT 06801 | Grocery Beer | 2020-04-18 ~ 2021-04-17 |
| Marilu F Jeton | 36 Weed Rd, Bethel, CT 06801 | Combination Nail Technician, Esthetician Or Eyelash Technici | ~ |
| Petagay V Hewitt | 44 Greenwood Avenue, Bethel, CT 06801 | Real Estate Salesperson | ~ |
| Find all Licenses in zip 06801 | |||
| City | BETHEL |
| Zip Code | 06801 |
| License Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| License Type + County | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER + BETHEL |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| David J Blum | 61 Hampden Ln, Irvington, NY 10533-2424 | Controlled Substance Registration for Practitioner | 2019-10-02 ~ 2021-02-28 |
| Asher B Blum | 163 Viscount Dr, Williamsville, NY 14221 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Ruth D Blum | 235 Townhouse, Hershey, PA 17033-2324 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Ryan W Blum | 300 George St Ste 901, New Haven, CT 06511-6662 | Controlled Substance Registration for Practitioner | 2015-03-01 ~ 2017-02-28 |
| Eliot H Blum | 611 Whitney Ave Apt 2a, New Haven, CT 06511-2283 | Controlled Substance Registration for Practitioner | 2017-03-01 ~ 2019-02-28 |
| Jennifer E Blum | 157 Brewster Rd, West Hartford, CT 06117-2102 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Theodore Lidz Md | Apartment 522, Hamden, CT 06517-2723 | Controlled Substance Registration for Practitioner | 1996-03-01 ~ 1997-02-28 |
| Theodore K Chang | 88 Brownstone Way Apt 104, Englewood, NJ 07631-1202 | Controlled Substance Registration for Practitioner | 2017-03-02 ~ 2019-02-28 |
| Kim Kit Yeng Wong | 110 Theodore Fremd Ave Apt B8, Rye, NY 10580-2874 | Controlled Substance Registration for Practitioner | 2019-10-16 ~ 2021-02-28 |
| Theodore P Gluckman Dds | 251 Main St, Westport, CT 06880 | Controlled Substance Registration for Practitioner | 1996-09-01 ~ 1998-02-28 |
Please comment or provide details below to improve the information on THEODORE J BLUM MD.
| 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).