JENNIFER M BLAIR MD (Credential# 564523) is licensed (Physician/surgeon) with Connecticut Department of Consumer Protection. The license effective date is January 1, 2013. The license expiration date date is December 31, 2013. The license status is INACTIVE.
JENNIFER M BLAIR MD is licensed with the Department of Consumer Protection of Connecticut. The credential number is #1.046941. The credential type is physician/surgeon. The effective date is January 1, 2013. The expiration date is December 31, 2013. The business address is 6016 Ponca St, Austin, TX 78741. The current status is inactive.
| Licensee Name | JENNIFER M BLAIR MD |
| Credential ID | 564523 |
| Credential Number | 1.046941 |
| Credential Type | Physician/Surgeon |
| Business Address |
6016 Ponca St Austin TX 78741 |
| Business Type | INDIVIDUAL |
| Status | INACTIVE - LAPSED DUE TO NON-RENEWAL |
| Issue Date | 2008-08-26 |
| Effective Date | 2013-01-01 |
| Expiration Date | 2013-12-31 |
| Refresh Date | 2014-04-05 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 915826 | CSP.0047284 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 2010-02-26 | 2011-03-01 - 2013-02-28 | INACTIVE |
| Street Address | 6016 Ponca St |
| City | Austin |
| State | TX |
| Zip Code | 78741 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Kimberly A Phaneuf · Chartier | 1704 Arcilla St, Putnam, TX 78741 | Registered Nurse | 2020-04-01 ~ 2021-03-31 |
| Allison Schneider | 3005 Sunridge Drive, Austin, TX 78741 | Interior Designer | 2018-01-01 ~ 2018-12-31 |
| Suzanne L Pixley | 2008a Kenneth, Austin, TX 78741 | Registered Nurse | 1993-01-25 ~ 1994-01-31 |
| Ellen E Bartolucci | 2336 Douglas Street, Austin, TX 78741 | Licensed Practical Nurse | 1998-01-15 ~ 1998-10-31 |
| Michael S Guertin | 1616 Sunny Vale St, Austin, TX 78741 | Pharmacist | 1800-12-27 ~ 1989-03-31 |
| Jordan A Krupa | 1500 Royal Crest Dr Apt 353, Austin, TX 78741-2708 | Hairdresser/cosmetician | 2020-03-01 ~ 2022-02-28 |
| Chelsea E Reidhaar | 1500 Royal Crest Dr Apt 353, Austin, TX 78741-2708 | Hairdresser/cosmetician | 2018-11-01 ~ 2020-10-31 |
| Kari H Barrett · Hardy | 1602 Whitney Way, Austin, TX 78741-3220 | Hairdresser/cosmetician | 2019-01-01 ~ 2020-12-31 |
| Deborah D Villalta | 1101 Grove Blvd Apt 708, Austin, TX 78741-3513 | Registered Nurse | 2018-11-01 ~ 2019-11-30 |
| Stephanie Marie Gonzales | 6505 Porter St Unit B, Austin, TX 78741-3517 | Registered Nurse - Temporary | 2019-06-19 ~ 2019-10-17 |
| Find all Licenses in zip 78741 | |||
| City | Austin |
| Zip Code | 78741 |
| License Type | Physician/Surgeon |
| License Type + County | Physician/Surgeon + Austin |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Blair S Lewis | 1067 Fifth Ave, New York, NY 10128 | Physician/surgeon | 2009-02-11 ~ 2009-11-30 |
| Arturo N Dinicola | 19 Blair Ln, Falmouth, MA 02540-3003 | Physician/surgeon | 2015-09-01 ~ 2016-09-30 |
| Charles L Blair | 836 Farmington Avenue, West Hartford, CT 06119 | Physician/surgeon | 2020-06-01 ~ 2021-05-31 |
| Dana Blair Devito | 23 Canaan Close, New Canaan, CT 06840-4920 | Physician/surgeon | 2018-09-01 ~ 2019-08-31 |
| Jim Blair Jr · Jim Blair Restoration | 8 Woodcock Lane, Westport, CT 06880 | Home Improvement Contractor | 1995-05-08 ~ 1995-11-30 |
| Jack J Blair | 1616 Post Rd #1134, Fairfield, CT 06430 | Home Improvement Contractor | ~ 1995-07-01 |
| Blair Manor | 612 Hazard Ave, Enfield, CT 06082-4225 | Chronic & Convalescent Nursing Home | 2016-10-01 ~ 2018-09-30 |
| Jennifer L Blair | 1704 T St Nw Apt 102, Washington, DC 20009-7104 | Occupational Therapist | 2013-08-01 ~ 2015-07-31 |
| Jennifer Lax Md | 23 Old Stone Bridge Rd, Cos Cob, CT 06807-1511 | Physician/surgeon | 2003-05-16 ~ 2004-02-29 |
| Jennifer L Yeh Md | 4 Smith Dr, Savannah, GA 31406-6441 | Physician/surgeon | 2012-12-01 ~ 2013-11-30 |
Please comment or provide details below to improve the information on JENNIFER M BLAIR MD.
| 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).