GUILLERMO ALBERTO ORTIZ SAN JUAN (Credential# 1519768) is licensed (Resident Physician) with Connecticut Department of Consumer Protection. The license effective date is July 1, 2018. The license expiration date date is June 30, 2021. The license status is ACTIVE.
GUILLERMO ALBERTO ORTIZ SAN JUAN is licensed with the Department of Consumer Protection of Connecticut. The credential number is #1.061279-RES. The credential type is resident physician. The effective date is July 1, 2018. The expiration date is June 30, 2021. The business address is 255 Promenade St Apt 119, Providence, RI 02908-5752. The current status is active.
| Licensee Name | GUILLERMO ALBERTO ORTIZ SAN JUAN |
| Credential ID | 1519768 |
| Credential Number | 1.061279-RES |
| Credential Type | Resident Physician |
| Credential SubCategory | RES |
| Business Address |
255 Promenade St Apt 119 Providence RI 02908-5752 |
| Business Type | INDIVIDUAL |
| Status | ACTIVE - CURRENT |
| Active | 1 |
| Issue Date | 2018-07-01 |
| Effective Date | 2018-07-01 |
| Expiration Date | 2021-06-30 |
| Refresh Date | 2020-05-27 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 1516291 | CSP.0068205 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 2018-06-01 | 2019-03-01 - 2021-02-28 | ACTIVE |
| 1501380 | 1 | Physician/Surgeon | - | PENDING |
| Street Address | 255 PROMENADE ST APT 119 |
| City | PROVIDENCE |
| State | RI |
| Zip Code | 02908-5752 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Olivia S Locker | 302 Eaton St, Providence, RI 02908 | Physician/surgeon | 2020-05-01 ~ 2021-04-30 |
| Alexandra Jimenez | 405 Promenade Street, Providence, RI 02908 | Physician/surgeon | 2020-05-01 ~ 2021-04-30 |
| Juan O Silfa | 15 Amity St., Providence, RI 02908 | Casino Class I Employee | 2019-12-11 ~ 2020-10-31 |
| Caitlyn M. Bouchard | 685 River Ave, Providence, RI 02908 | Casino Class I Employee | 2019-12-18 ~ 2020-10-31 |
| Brandon Russell Sweet | 38 Durham Street, Providence, RI 02908 | Casino Class I Employee | 2019-12-11 ~ 2020-10-31 |
| Howard J Sellers | 88 Jewett Street, Providence, RI 02908 | Casino Class I Employee | 2019-12-03 ~ 2020-10-31 |
| Khonesavanh Misay | 25 Rosebank Avenue, Providence, RI 02908 | Casino Class I Employee | 2019-12-11 ~ 2020-10-31 |
| Alan R Morrison | Providence Va Medical Center, Providence, RI 02908 | Physician/surgeon | 2020-03-01 ~ 2021-02-28 |
| Tiffany Acosta | 34 Veazie St 3rd Flr, Providence, RI 02908 | Registered Nurse | ~ |
| Tomas I Perez | 80 Farragut Ave, Providence, RI 02908 | Professional Engineer | 2019-06-21 ~ 2020-01-31 |
| Find all Licenses in zip 02908 | |||
| City | PROVIDENCE |
| Zip Code | 02908 |
| License Type | Resident Physician |
| License Type + County | Resident Physician + PROVIDENCE |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Juan Alberto Cerrutti | 15 Sagamore Ln Unit 305, Rocky Hill, CT 06067-3850 | Resident Dentist | 2017-07-01 ~ 2019-06-30 |
| Juan Flores | 24 Hospital Ave, Danbury, CT 06810-6099 | Resident Physician | 2019-06-20 ~ 2022-06-30 |
| Juan Ed Torres-reveron | 20 York St., New Haven, CT 06510-3220 | Resident Physician | 2014-07-01 ~ 2020-06-30 |
| Juan G Rodriguez Guzman | 300 George St Ste 901, New Haven, CT 06511-6662 | Resident Physician | 2017-06-12 ~ 2021-06-30 |
| Juan J Silva Campos | 20 York St, New Haven, CT 06510 | Resident Physician | 2020-06-24 ~ 2021-06-30 |
| Guillermo Ortiz | 115 Short Beach Rd #106, Stratford, CT 06615 | Real Estate Salesperson | ~ |
| Juan Joseph Young | Yale School of Medicine, New Haven, CT 06511 | Resident Physician | 2019-07-15 ~ 2021-06-30 |
| Maria Eugenia Garcia-ayala | Calle Juan R. Ramos V-24, Guaynabo, PR 00969 | Resident Physician | 2020-07-01 ~ 2021-06-30 |
| Giovanni Alberto Ortiz | 35 Counselor Dr, Naugatuck, CT 06770-3173 | Barber | ~ |
| Alberto Ortiz | 310 Hill St, Waterbury, CT 06704-2614 | Electrical Unlimited Journeyperson | ~ |
Please comment or provide details below to improve the information on GUILLERMO ALBERTO ORTIZ SAN JUAN.
| 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).