DALLIAH M BLACK MD (Credential# 562053) is licensed (Physician/surgeon) with Connecticut Department of Consumer Protection. The license effective date is August 21, 2007. The license expiration date date is September 30, 2008. The license status is INACTIVE.
DALLIAH M BLACK MD is licensed with the Department of Consumer Protection of Connecticut. The credential number is #1.044471. The credential type is physician/surgeon. The effective date is August 21, 2007. The expiration date is September 30, 2008. The business address is Department of Surgery, New Haven, CT 06520. The current status is inactive.
| Licensee Name | DALLIAH M BLACK MD |
| Credential ID | 562053 |
| Credential Number | 1.044471 |
| Credential Type | Physician/Surgeon |
| Business Address |
Department of Surgery New Haven CT 06520 |
| Business Type | INDIVIDUAL |
| Status | INACTIVE - LAPSED DUE TO NON-RENEWAL |
| Issue Date | 2006-06-16 |
| Effective Date | 2007-08-21 |
| Expiration Date | 2008-09-30 |
| Refresh Date | 2009-07-11 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 442960 | CSP.0039429 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 2006-07-13 | 2007-03-01 - 2008-02-29 | INACTIVE |
| Street Address | DEPARTMENT OF SURGERY |
| City | NEW HAVEN |
| State | CT |
| Zip Code | 06520 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Manuel I Rodriguez-davalos | Department of Surgery, New Haven, CT 06520 | Controlled Substance Registration for Practitioner | 2017-03-01 ~ 2019-02-28 |
| W Scott Helton Md | Department of Surgery, New Haven, CT 06511 | Physician/surgeon | 2010-11-01 ~ 2011-10-31 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Orchestra New England | P.o. Box 200123, New Haven, CT 06520 | Public Charity | 2019-06-01 ~ 2020-05-31 |
| Catherine A Dinauer | 333 Cedar St., Fmb 131, New Haven, CT 06520 | Physician/surgeon | 2020-07-01 ~ 2021-06-30 |
| Kofi Agyare Mensah | 300 Cedar Street, New Haven, CT 06520 | Physician/surgeon | 2020-07-01 ~ 2021-06-30 |
| Kevin Huang | 330 Cedar Street, New Haven, CT 06520 | Physician/surgeon | 2020-08-01 ~ 2021-07-31 |
| Mubdiul Imtiaz Ali | 300 Cedar St, Tac S425, New Haven, CT 06520 | Physician/surgeon | 2020-07-01 ~ 2021-06-30 |
| Dr Akhil Khosla | 300 Cedar St, Tac S425 P.o. Box 208057, New Haven, CT 06520 | Physician/surgeon | 2020-09-01 ~ 2021-08-31 |
| Scott N Gettinger Md | 333 Cedar St-yale Cancer Center, New Haven, CT 06520 | Physician/surgeon | 2020-09-01 ~ 2021-08-31 |
| Lindsay Sarah Mcalpine | Yale -new Haven Hospital, New Haven, CT 06520 | Resident Physician | 2020-07-01 ~ 2021-06-30 |
| Michael Hurwitz | 333 Cedar St Www211, New Haven, CT 06520 | Physician/surgeon | 2020-09-01 ~ 2021-08-31 |
| Patrick M Popiel | Yale University, Department of Ob/gyn, New Haven, CT 06520 | Resident Physician | 2017-07-01 ~ 2021-06-30 |
| Find all Licenses in zip 06520 | |||
| City | NEW HAVEN |
| Zip Code | 06520 |
| License Type | Physician/Surgeon |
| License Type + County | Physician/Surgeon + NEW HAVEN |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Jed E Black | 200 Evergreen Ave, Hamden, CT 06518 | Physician/surgeon | 1992-03-24 ~ 1993-02-28 |
| Robert D Black Md | 330 Blake Cir, Hamden, CT 06517 | Physician/surgeon | 2020-06-01 ~ 2021-05-31 |
| Elyse R. Erlich | 18 Black Birch Ln, Scarsdale, NY 10583-7455 | Physician/surgeon | 2020-07-01 ~ 2021-06-30 |
| Aftab A Awan | 56 Black Rock Ave, Apt 1, New Britain, CT 06052 | Physician/surgeon | 2000-06-01 ~ 2001-06-30 |
| Debra L Gerson | 64 Black Rock Ave, Bridgeport, CT 06605-1200 | Physician/surgeon | 2018-03-01 ~ 2019-02-28 |
| Richard H Dyer Jr | 306 Black Rock Rd, Watertown, CT 06795-1417 | Physician/surgeon | 2010-07-01 ~ 2011-06-30 |
| Laura Black | 26 Burlington Road, Unionville, CT 06085 | Physician/surgeon | 2020-07-01 ~ 2021-06-30 |
| Dan C Omohundro | 2371 Black Rock Tpk, Fairfield, CT 06432 | Physician/surgeon | 2016-05-01 ~ 2017-04-30 |
| Robert L Plansky | 39 Black Twig Pl, Stamford, CT 06903-1835 | Physician/surgeon | 2019-12-01 ~ 2020-11-30 |
| Jerilyn S Allen Md | 220 Old Black Point Rd, Niantic, CT 06357 | Physician/surgeon | 2020-06-01 ~ 2021-05-31 |
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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).