CARLOS R IBANEZ MD (Credential# 741735) is licensed (Dental Anesthesia/conscious Sedation Permit) with Connecticut Department of Consumer Protection. The license effective date is May 16, 2008. The license expiration date date is June 30, 2009. The license status is INACTIVE.
CARLOS R IBANEZ MD is licensed with the Department of Consumer Protection of Connecticut. The credential number is #22.008433. The credential type is dental anesthesia/conscious sedation permit. The effective date is May 16, 2008. The expiration date is June 30, 2009. The business address is School of Dental Medicine/omfs-l7073, Farmington, CT 06030. The current status is inactive.
| Licensee Name | CARLOS R IBANEZ MD |
| Credential ID | 741735 |
| Credential Number | 22.008433 |
| Credential Type | Dental Anesthesia/Conscious Sedation Permit |
| Business Address |
School of Dental Medicine/omfs-l7073 Farmington CT 06030 |
| Business Type | INDIVIDUAL |
| Status | INACTIVE - LAPSED DUE TO NON-RENEWAL |
| Issue Date | 2006-06-14 |
| Effective Date | 2008-05-16 |
| Expiration Date | 2009-06-30 |
| Refresh Date | 2009-11-02 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 703896 | 2.009444 | Dentist | 2005-06-07 | 2008-03-26 - 2009-04-30 | INACTIVE |
| 407703 | CSP.0037638 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 2005-06-14 | 2008-04-02 - 2009-02-28 | INACTIVE |
| Street Address | SCHOOL OF DENTAL MEDICINE/OMFS-L7073 |
| City | FARMINGTON |
| State | CT |
| Zip Code | 06030 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Eric Anthony Brueckner | 263 Farmington Ave., Farmington, CT 06030 | Physician/surgeon | 2020-08-01 ~ 2021-07-31 |
| Derrick B Bremang | Residency Program, Farmington, CT 06030 | Physician/surgeon | 2020-06-01 ~ 2021-06-30 |
| David M Shafer | Uconn Health Center, Farmington, CT 06030 | Dentist | 2020-07-01 ~ 2021-06-30 |
| Michael J Murphy | Dept of Dermatology, Farmington, CT 06030 | Physician/surgeon | 2020-09-01 ~ 2021-08-31 |
| Richard F Kaplan | Univ. of Ct., Farmington, CT 06030 | Psychologist | 2020-06-01 ~ 2021-05-31 |
| Nicholas George Vitale | 22 Woods Drive, Norwich, CT 06030 | Casino Class I Employee | 2019-12-03 ~ 2020-10-31 |
| Bruce E Gould | Univ of Conn Health Center, Farmington, CT 06030 | Physician/surgeon | 2020-04-01 ~ 2021-03-31 |
| Vinayak M Sathe | Uconn Health Center,263 Farmington Ave, Farmington, CT 06030 | Physician/surgeon | 2020-06-01 ~ 2021-05-31 |
| Shobhana Pathani | Department of Medicine, 263 Farmington Ave, CT 06030 | Physician/surgeon | 2020-06-01 ~ 2021-05-31 |
| Patricia L Almeida | John Dempsey Hospital, Farmington, CT 06030 | Registered Nurse | 2020-04-01 ~ 2021-03-31 |
| Find all Licenses in zip 06030 | |||
| City | FARMINGTON |
| Zip Code | 06030 |
| License Type | Dental Anesthesia/Conscious Sedation Permit |
| License Type + County | Dental Anesthesia/Conscious Sedation Permit + FARMINGTON |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Steven E. Smullin | 10 South St Ste 202, Ridgefield, CT 06877-4125 | Dental Anesthesia/conscious Sedation Permit | 2020-06-01 ~ 2021-05-31 |
| Daniel J. Gill | 34 Dale Rd Ste 105, Avon, CT 06001-3659 | Dental Anesthesia/conscious Sedation Permit | 2020-09-01 ~ 2021-08-31 |
| Christopher J Cuomo | 16 Cannon Dr, Newtown, CT 06470-1751 | Dental Anesthesia/conscious Sedation Permit | 2020-08-01 ~ 2021-07-31 |
| George A Murphy IIi | 110 Hopmeadow St, Weatogue, CT 06089-9407 | Dental Anesthesia/conscious Sedation Permit | 2020-06-01 ~ 2021-05-31 |
| David E Prindiville Dmd | 310 Timrod Rd, Manchester, CT 06040-6734 | Dental Anesthesia/conscious Sedation Permit | 2011-05-01 ~ 2015-04-30 |
| Garrick Alex | 23 Maple Ave, Greenwich, CT 06830-5620 | Dental Anesthesia/conscious Sedation Permit | 2020-05-20 ~ 2021-05-31 |
| Abra J Dilisio | 103 The Waterway, Manhasset, NY 11030-1331 | Dental Anesthesia/conscious Sedation Permit | 2020-07-01 ~ 2021-06-30 |
| Eric S Han | 697 Poquonock Avenue, Windsor, CT 06095 | Dental Anesthesia/conscious Sedation Permit | 2020-06-01 ~ 2021-05-31 |
| Jordan A Greenberg | 500 E Main St Ste 216, Branford, CT 06405-2937 | Dental Anesthesia/conscious Sedation Permit | 2020-09-01 ~ 2021-08-31 |
| Donald J Case Dmd | 27 Bridge St, Stamford, CT 06905 | Dental Anesthesia/conscious Sedation Permit | 2020-05-01 ~ 2021-04-30 |
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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).