BENJAMIN J FREDA DO (Credential# 561975) is licensed (Physician/surgeon) with Connecticut Department of Consumer Protection. The license effective date is September 1, 2014. The license expiration date date is August 31, 2015. The license status is INACTIVE.
BENJAMIN J FREDA DO is licensed with the Department of Consumer Protection of Connecticut. The credential number is #1.044393-DO. The credential type is physician/surgeon. The effective date is September 1, 2014. The expiration date is August 31, 2015. The business address is 100 Wason Ave Ste 200, Springfield, MA 01107-1119. The current status is inactive.
| Licensee Name | BENJAMIN J FREDA DO |
| Credential ID | 561975 |
| Credential Number | 1.044393-DO |
| Credential Type | Physician/Surgeon |
| Credential SubCategory | DO |
| Business Address |
100 Wason Ave Ste 200 Springfield MA 01107-1119 |
| Business Type | INDIVIDUAL |
| Status | INACTIVE - LAPSED DUE TO NON-RENEWAL |
| Issue Date | 2006-05-24 |
| Effective Date | 2014-09-01 |
| Expiration Date | 2015-08-31 |
| Refresh Date | 2015-12-04 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 443458 | CSP.0039456 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 2006-07-12 | 2013-03-01 - 2015-02-28 | INACTIVE |
| Street Address | 100 WASON AVE STE 200 |
| City | SPRINGFIELD |
| State | MA |
| Zip Code | 01107-1119 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Dennis J Dicampli Md | 100 Wason Ave Ste 200, Springfield, MA 01107-1179 | Physician/surgeon | 2020-07-01 ~ 2021-06-30 |
| Shaji P Daniel | 100 Wason Ave Ste 200, Springfield, MA 01107-1179 | Physician/surgeon | 2020-06-01 ~ 2021-05-31 |
| Barbara A Greco Md | 100 Wason Ave Ste 200, Springfield, MA 01107-1119 | Physician/surgeon | 2020-06-01 ~ 2021-05-31 |
| Neeraj Jain | 100 Wason Ave Ste 200, Springfield, MA 01107-1179 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Jonathan Slater | 100 Wason Ave Ste 200, Springfield, MA 01107-1179 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Hemant Magoo | 100 Wason Ave Ste 200, Springfield, MA 01107 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| George Fares Md | 100 Wason Ave Ste 200, Springfield, MA 01107-1118 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Krishnan Babu | 100 Wason Ave Ste 200, Springfield, MA 01107-1179 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Ashish Verma | 100 Wason Ave Ste 200, Springfield, MA 01107 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Stephen Sweet Md | 100 Wason Ave Ste 200, Springfield, MA 01107-1179 | Controlled Substance Registration for Practitioner | 2015-03-01 ~ 2017-02-28 |
| Find all Licenses in the same address | |||
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| David M Chadbourne | 100 Wason Ave Ste 240, Springfield, MA 01107-1119 | Physician/surgeon | 2013-12-01 ~ 2014-11-30 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Lauren Elizabeth Marshall | 945 Armory St, Springfield, MA 01107 | Physician Assistant | 2020-04-01 ~ 2021-03-31 |
| Jennifer L Fish | 367 Union Street, Springfield, MA 01107 | Hairdresser/cosmetician | ~ |
| Joseph Pagan | 59 Rowland Street, Springfield, MA 01107 | Medication Administration Certification | 2020-04-20 ~ 2022-04-19 |
| Daniel Laguerre | 382 Springfield St, Springfield, MA 01107 | Crane Operator | ~ |
| Kamal Kant Kalia | 2 Medical Center Drive, Springfield, MA 01107 | Physician/surgeon | 2020-03-01 ~ 2021-02-28 |
| Bushee Enterprises LLC | Po Box 1196, Southwick, MA 01107 | Home Improvement Contractor | 2015-12-01 ~ 2016-11-30 |
| B Lopez | 165 Prospect Street, Springfield, MA 01107 | Notary Public Appointment | 2011-10-01 ~ 2016-09-30 |
| Beth C Mcinerny | 260 Ware Road, Belchertown, MA 01107 | Registered Nurse | 2019-12-01 ~ 2020-11-30 |
| Jorge Enrique Rivera | 20 Narragansett Street, Springfield, MA 01107 | Professional Counselor | 2019-10-01 ~ 2020-09-30 |
| Rachael Hynds-decoteau | 22 Candice Cir, Springfield, MA 01107 | Controlled Substance Registration for Practitioner | 2019-09-19 ~ 2021-02-28 |
| Find all Licenses in zip 01107 | |||
| City | SPRINGFIELD |
| Zip Code | 01107 |
| License Type | Physician/Surgeon |
| License Type + County | Physician/Surgeon + SPRINGFIELD |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Freda O Boateng Md | 2795 Cathedral Rock Way, Dublin, CA 94568 | Physician/surgeon | 2020-04-01 ~ 2021-03-31 |
| Benjamin Richard Jacobs | CT | Physician/surgeon | ~ 1992-03-31 |
| Benjamin Stein | 161 Madison Ave, New York, NY 10016 | Physician/surgeon | ~ |
| Benjamin D Gordon Md | 14 Hillsea Rd, Yarmouth, MD 02675-1111 | Physician/surgeon | 2003-01-16 ~ 2004-03-31 |
| Benjamin H Lee | 2005 Hillmeade Dr, Nashville, TN 37221 | Physician/surgeon | 1997-05-12 ~ 1998-07-31 |
| Benjamin Stein | 161 Madison Avenue, New York, NY 10016 | Physician/surgeon | ~ |
| Benjamin Lord Jr | 405 Washington St, Norwich, CT 06360 | Physician/surgeon | 1997-02-04 ~ 1998-02-28 |
| Benjamin J Wycherly Md | 21 South Rd Ste 112, Farmington, CT 06032-2482 | Physician/surgeon | 2020-03-01 ~ 2021-02-28 |
| Benjamin Kahn | 40 Abrams Rd, Cheshire, CT 06410 | Physician/surgeon | 2020-06-01 ~ 2021-05-31 |
| Benjamin J Gilson | 18 Chestnut St, Newport, RI 02840 | Physician/surgeon | 1993-09-23 ~ 1994-08-31 |
Please comment or provide details below to improve the information on BENJAMIN J FREDA DO.
| 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).