RAFAH SALLOUM MD (Credential# 558474) is licensed (Physician/surgeon) with Connecticut Department of Consumer Protection. The license effective date is December 1, 2011. The license expiration date date is November 30, 2012. The license status is INACTIVE.
RAFAH SALLOUM MD is licensed with the Department of Consumer Protection of Connecticut. The credential number is #1.040891. The credential type is physician/surgeon. The effective date is December 1, 2011. The expiration date is November 30, 2012. The business address is 53 Woodhollow, Colts Neck, NJ 07722. The current status is inactive.
| Licensee Name | RAFAH SALLOUM MD |
| Credential ID | 558474 |
| Credential Number | 1.040891 |
| Credential Type | Physician/Surgeon |
| Business Address |
53 Woodhollow Colts Neck NJ 07722 |
| Business Type | INDIVIDUAL |
| Status | INACTIVE - LAPSED DUE TO NON-RENEWAL |
| Issue Date | 2002-10-09 |
| Effective Date | 2011-12-01 |
| Expiration Date | 2012-11-30 |
| Refresh Date | 2013-03-06 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 318260 | CSP.0032579 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 2008-03-01 - 2009-02-28 | INACTIVE |
| Street Address | 53 WOODHOLLOW |
| City | COLTS NECK |
| State | NJ |
| Zip Code | 07722 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Fermina M Mazzella | 131 Stone Hill Road, Colts Neck, NJ 07722 | Physician/surgeon | 2020-02-01 ~ 2021-01-31 |
| Alicia Meehan | 3 Ramapo Ct, Colts Neck, NJ 07722 | Occupational Therapist | ~ |
| Daniel J Cardellichio | 265 Highway 34 Suite D, Colts Neck, NJ 07722 | Chiropractor | 2015-02-01 ~ 2016-01-31 |
| Wael Ghali Md | 53 Woodhollow Rd, Colts Neck, NJ 07722 | Physician/surgeon | 2011-11-01 ~ 2012-10-31 |
| Paul V. Jensen Jr. | 2 Comstock Ln, Colts Neck, NJ 07722 | Certified Public Accountant License | 2009-01-01 ~ 2009-12-31 |
| John A Flanagan | 4 Pilgrim Way, Colts Neck, NJ 07722 | Certified Public Accountant License | 1997-01-01 ~ 1997-12-31 |
| Anthony J Kolasa | 11 Applethorn Ct, Colts Neck, NJ 07722 | Certified Public Accountant License | 2009-01-01 ~ 2009-12-31 |
| John J. Witkowski | 50 The Enclosure, Colts Neck, NJ 07722 | Certified Public Accountant License | 2005-01-01 ~ 2005-12-31 |
| Gabriel Frassetti | 65 Prothero Road, Colts Neck, NJ 07722 | Asbestos Abatement Supervisor | 2008-10-23 ~ 2009-07-31 |
| Sandra K Meadow | 240-b Swimming River Rd, Colts Neck, NJ 07722 | Veterinarian | 2003-01-23 ~ 2004-01-31 |
| Find all Licenses in zip 07722 | |||
| City | COLTS NECK |
| Zip Code | 07722 |
| License Type | Physician/Surgeon |
| License Type + County | Physician/Surgeon + COLTS NECK |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Ahmad Salloum | 24 Kentucky Way, Freehold, NJ 07728 | Physician/surgeon | 2004-05-14 ~ 2005-05-31 |
| Sadek Salloum Md | 175 Mill Pond Road Apt #123, Hamden, CT 06514 | Physician/surgeon | 1998-02-09 ~ 1999-02-28 |
| Didi Salloum | 200 John Olds Drive, Apt 207, Manchester, CT 06040 | Physician/surgeon | 2000-12-28 ~ 2001-04-30 |
| Rafah Ventures LLC | 954 E Main St, Meriden, CT 06450-6010 | Dealer of Electronic Nicotine Delivery System Or Vapor Product | 2020-02-29 ~ 2021-02-28 |
| Cynthia Salloum Md | 5 Cummings Ave 1st Fl, Stamford, CT 06902 | Controlled Substance Registration for Practitioner | 1997-03-01 ~ 1998-02-28 |
| Amer Salloum | 4 Lillian Drive, Trumbull, CT 06611 | Real Estate Salesperson | 2019-06-01 ~ 2020-05-31 |
| Ahmad Salloum Md | 307 Shawnee Dr., Brick, NJ 08724 | Controlled Substance Registration for Practitioner | 2002-01-17 ~ 2003-02-28 |
| Emile Salloum Md | Spohn Towers, Corpus Christi, TX 78404 | Controlled Substance Registration for Practitioner | 1998-03-01 ~ 1999-02-28 |
| Gilbert L Drozdow | Envision Physician Services, Plantation, FL 33322 | Physician/surgeon | 2019-10-01 ~ 2020-09-30 |
| Russell H Harris Md | Envision Physician Services, Horsham, PA 19044 | Physician/surgeon | 2019-09-01 ~ 2020-08-31 |
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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).