KATHERINE A BLOOM
Controlled Substance Registration for Practitioner


Address: 55 Walls Drive, Fairfield, CT 06824

KATHERINE A BLOOM (Credential# 536706) 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.

Business Overview

KATHERINE A BLOOM is licensed with the Department of Consumer Protection of Connecticut. The credential number is #CSP.0045733. 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 55 Walls Drive, Fairfield, CT 06824. The current status is active.

Basic Information

Licensee Name KATHERINE A BLOOM
Credential ID 536706
Credential Number CSP.0045733
Credential Type CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER
Business Address 55 Walls Drive
Fairfield
CT 06824
Business Type INDIVIDUAL
Status ACTIVE - CURRENT
Active 1
Issue Date 2009-07-02
Effective Date 2019-03-01
Expiration Date 2021-02-28
Refresh Date 2019-02-07

Other licenses

ID Credential Code Credential Type Issue Term Status
565289 1.047707 Physician/Surgeon 2009-05-15 2019-08-01 - 2020-07-31 ACTIVE

Office Location

Street Address 55 Walls Drive
City Fairfield
State CT
Zip Code 06824

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Competitor

Search similar business entities

City Fairfield
Zip Code 06824
License Type CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER
License Type + County CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER + Fairfield

Similar businesses

Licensee Name Office Address Credential Effective / Expiration
Todd E Bloom 760 Kings Hwy W, Southport, CT 06890-1107 Controlled Substance Registration for Practitioner 2019-04-01 ~ 2021-02-28
Peter E Bloom Jr 25 Newell Rd Ste E36, Bristol, CT 06010-5132 Controlled Substance Registration for Practitioner 2019-03-01 ~ 2021-02-28
Gregory S Bloom Md 112 Quarry Rd Ste 400, Trumbull, CT 06611 Controlled Substance Registration for Practitioner 2019-03-01 ~ 2021-02-28
Justin R. Bloom Po Box 806, East Windsor, CT 06088 Controlled Substance Registration for Practitioner 2019-03-01 ~ 2021-02-28
David I Bloom Md 2 Bridge Lane, Enfield, CT 06083 Controlled Substance Registration for Practitioner ~
Jeffrey N Bloom Md 3020 Westchester Ave Ste 402, Purchase, NY 10577 Controlled Substance Registration for Practitioner 2007-03-01 ~ 2008-02-29
Maxine Bloom 14 Bauer Place, Westport, CT 06880-2138 Controlled Substance Registration for Practitioner 2019-03-01 ~ 2021-02-28
David I Bloom Jr 1060 Day Hill Road, Windsor, CT 06095 Controlled Substance Registration for Practitioner 2019-03-01 ~ 2021-02-28
Katherine Prioli P.o.box 346, Uncasville, CT 06382-0346 Controlled Substance Registration for Practitioner 2008-03-01 ~ 2009-02-28
Katherine Y Lee 840 Flintlock Rd, Southport, CT 06890-3044 Controlled Substance Registration for Practitioner 2017-03-01 ~ 2019-02-28

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Dataset Information

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).

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