BENOIT BLONDEAU (Credential# 1595500) 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 INACTIVE.
BENOIT BLONDEAU is licensed with the Department of Consumer Protection of Connecticut. The credential number is #CSP.0069408. 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 263 Farmington Ave, Farmington, CT 06030-0001. The current status is inactive.
| Licensee Name | BENOIT BLONDEAU |
| Credential ID | 1595500 |
| Credential Number | CSP.0069408 |
| Credential Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| Business Address |
263 Farmington Ave Farmington CT 06030-0001 |
| Business Type | INDIVIDUAL |
| Status | INACTIVE - LACK OF ACTIVE MEDICAL LICENSE |
| Issue Date | 2018-08-27 |
| Effective Date | 2019-03-01 |
| Expiration Date | 2021-02-28 |
| Refresh Date | 2020-04-24 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 1518902 | 1.061151-RES | Resident Physician | 2018-08-01 | 2018-08-01 - 2019-08-19 | INACTIVE |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Benoit Blondeau | 414 W 68 Ter, Kansas City, MO 64113 | Physician/surgeon | ~ |
| Street Address | 263 FARMINGTON AVE |
| City | FARMINGTON |
| State | CT |
| Zip Code | 06030-0001 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Erica Shen Nofziger | 263 Farmington Ave, Farmington, CT 06030-0001 | Resident Physician | 2020-07-01 ~ 2027-06-30 |
| Matthew D Goranson | 263 Farmington Ave, Farmington, CT 06030-0001 | Resident Physician | 2020-07-01 ~ 2026-06-30 |
| Jacob Silver | 263 Farmington Ave, Farmington, CT 06030-0001 | Resident Physician | 2020-07-01 ~ 2025-06-30 |
| Nicholas Bellas | 263 Farmington Ave, Farmington, CT 06032-1956 | Resident Physician | 2020-07-01 ~ 2025-06-30 |
| Jennifer Hale | 263 Farmington Ave, Farmington, CT 06030-0001 | Resident Physician | 2020-07-01 ~ 2025-06-30 |
| Cory R Hewitt | 263 Farmington Ave, Farmington, CT 06030-0001 | Resident Physician | 2020-07-01 ~ 2025-06-30 |
| Sango Huwaa Mosia Asante | 263 Farmington Ave, Farmington, CT 06030-0001 | Resident Physician | 2020-07-01 ~ 2025-06-30 |
| Ryan Desrochers | 263 Farmington Ave, Farmington, CT 06030-0001 | Resident Physician | 2020-07-01 ~ 2025-06-30 |
| Kelsey D Greenhalgh | 263 Farmington Ave, Farmington, CT 06030-0001 | Resident Dentist | 2019-07-01 ~ 2025-06-30 |
| Derek J Tow | 263 Farmington Ave, Farmington, CT 06030-0001 | Resident Dentist | 2019-07-01 ~ 2025-06-30 |
| Find all Licenses in the same address | |||
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Wendy A Miller | Mc1921 Farmington Ave # 263, Farmington, CT 06030-0001 | Physician/surgeon | 2020-06-01 ~ 2021-05-31 |
| Jason J Ziegler | 2 Courthouse Square, Farmington, CT 06030-0001 | Real Estate Salesperson | 2020-06-01 ~ 2021-05-31 |
| Bryden T Considine | L2104 of Medicine Rm, Farmington, CT 06030-0001 | Resident Physician | 2017-07-03 ~ 2021-06-30 |
| Dillon Paulo | 4260 Cordoba Ct, Farmington, CT 06030-0001 | Resident Physician | 2020-07-01 ~ 2024-06-30 |
| Omar Ibrahim | 263 Farmington Ave # Mc-1321, Farmington, CT 06030-0001 | Physician/surgeon | 2020-06-01 ~ 2021-05-31 |
| Jillian L Fortier | Uconn Health Center, Department of Surgery, Farmington, CT 06030-0001 | Physician/surgeon | 2020-05-01 ~ 2021-04-30 |
| Douglas Zelisko | 263 Farmington Ave Dept Of, Farmington, CT 06030-0001 | Physician/surgeon | 2020-04-23 ~ 2021-01-31 |
| Ruchir D Trivedi | 263 Farmington Ave # Mc-1405, Farmington, CT 06030-0001 | Physician/surgeon | 2020-06-01 ~ 2021-05-31 |
| Rawan J.j. Sarsour | 263 Farmington Ave # Mc3905, Farmington, CT 06030-0001 | Provisional Faculty Dentist | 2020-04-21 ~ 2021-04-30 |
| Angela Hart | General Medicine- Outpatient Pavilion, Farmington, CT 06030-0001 | Physician/surgeon | 2020-05-01 ~ 2021-04-30 |
| Find all Licenses in zip 06030-0001 | |||
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Eric Anthony Brueckner | 263 Farmington Ave., Farmington, CT 06030 | Physician/surgeon | 2020-08-01 ~ 2021-07-31 |
| Derrick B Bremang | Residency Program, Farmington, CT 06030 | Physician/surgeon | 2020-06-01 ~ 2021-06-30 |
| David M Shafer | Uconn Health Center, Farmington, CT 06030 | Dentist | 2020-07-01 ~ 2021-06-30 |
| Michael J Murphy | Dept of Dermatology, Farmington, CT 06030 | Physician/surgeon | 2020-09-01 ~ 2021-08-31 |
| Richard F Kaplan | Univ. of Ct., Farmington, CT 06030 | Psychologist | 2020-06-01 ~ 2021-05-31 |
| Nicholas George Vitale | 22 Woods Drive, Norwich, CT 06030 | Casino Class I Employee | 2019-12-03 ~ 2020-10-31 |
| Bruce E Gould | Univ of Conn Health Center, Farmington, CT 06030 | Physician/surgeon | 2020-04-01 ~ 2021-03-31 |
| Vinayak M Sathe | Uconn Health Center,263 Farmington Ave, Farmington, CT 06030 | Physician/surgeon | 2020-06-01 ~ 2021-05-31 |
| Shobhana Pathani | Department of Medicine, 263 Farmington Ave, CT 06030 | Physician/surgeon | 2020-06-01 ~ 2021-05-31 |
| Patricia L Almeida | John Dempsey Hospital, Farmington, CT 06030 | Registered Nurse | 2020-04-01 ~ 2021-03-31 |
| Find all Licenses in zip 06030 | |||
| City | FARMINGTON |
| Zip Code | 06030 |
| License Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| License Type + County | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER + FARMINGTON |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Paul R Benoit Jr | 32 Wicklow Rd, Westerly, RI 02891-3644 | Controlled Substance Registration for Practitioner | 2015-03-01 ~ 2017-02-28 |
| Mary R Benoit | 1 Ambler Rd, Bristol, CT 06010-3523 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Karen Benoit | 7 Doherty Dr, Wallingford, CT 06492-2689 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Catherine A Benoit | 32 Wicklow Road, Westerly, RI 02891 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Evangeline M Benoit Aprn | 25 Tori Ln, Brookfield, CT 06804-3664 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Sancerre Celestin Blondeau | Connecticut Brand Registration, Hartford, CT 06106 | Liquor Brand Label | 2017-07-21 ~ 2020-07-19 |
| Benoit's · Wilfred J Benoit Inc | 167 Pkwy N Crossroads Shopping Plaza, Waterford, CT 06385 | Closing Out Sale | 2001-11-19 ~ 2002-02-16 |
| Steven Kassels Md · Community Substance Abuse Center | Comm. Physicians PC/125 North Elm Street, Westfield, MA 01085 | Controlled Substance Registration for Practitioner | 2018-06-15 ~ 2019-02-28 |
| Shu-i Lin | CT | Controlled Substance Registration for Practitioner | 2017-06-12 ~ 2019-02-28 |
| Erin K Fee | CT | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
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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).