IMRAN L BALOUCH MD (Credential# 906510) is licensed (Controlled Substance Registration for Practitioner) with Connecticut Department of Consumer Protection. The license effective date is March 1, 2015. The license expiration date date is February 28, 2017. The license status is INACTIVE.
IMRAN L BALOUCH MD is licensed with the Department of Consumer Protection of Connecticut. The credential number is #CSP.0047034. The credential type is controlled substance registration for practitioner. The effective date is March 1, 2015. The expiration date is February 28, 2017. The business address is 5105 N Glen Park Place, Peoria, IL 61614. The current status is inactive.
| Licensee Name | IMRAN L BALOUCH MD |
| Credential ID | 906510 |
| Credential Number | CSP.0047034 |
| Credential Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| Business Address |
5105 N Glen Park Place Peoria IL 61614 |
| Business Type | INDIVIDUAL |
| Status | INACTIVE |
| Issue Date | 2010-01-20 |
| Effective Date | 2015-03-01 |
| Expiration Date | 2017-02-28 |
| Refresh Date | 2018-01-29 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 900812 | 1.048248 | Physician/Surgeon | 2009-11-17 | 2015-12-01 - 2016-11-30 | INACTIVE |
| 448883 | CSP.0040494 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 2006-12-11 | 2007-03-01 - 2008-02-29 | INACTIVE |
| Street Address | 5105 N Glen Park Place |
| City | Peoria |
| State | IL |
| Zip Code | 61614 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Jenifer B Rodriguez | 808 W Pine Hill Lane, Peoria, IL 61614 | Physical Therapist | 2020-05-01 ~ 2021-04-30 |
| Michael J Mclaren | 6505 N Imperial Drive, Peroria, IL 61614 | Professional Engineer | 2020-02-01 ~ 2021-01-31 |
| James M Parrish | 4122 N. Grand Blvd., Peoria, IL 61614 | Professional Engineer | 2020-02-01 ~ 2021-01-31 |
| David A Muchow | 148 E Southgate Rd, Peoria, IL 61614 | Professional Engineer | 1989-05-31 ~ 1990-01-31 |
| Susan C Groves | 120 Alvin, East Peoria, IL 61614 | Registered Nurse | 2007-08-14 ~ 2008-09-30 |
| David A Oaks | 1717 East Terrace, Peoria, IL 61614 | Physician Assistant | ~ 1995-08-31 |
| Alison H Watkins | 223 W Hollyridge Cr, Peoria, IL 61614 | Registered Nurse | 1996-08-22 ~ 1997-10-31 |
| Suneet B Chauhan | 360 E High Point Rd, Peoria, IL 61614 | Physician/surgeon | 1992-04-24 ~ 1993-03-31 |
| Mindy K Kerrn | 3107 W Willow Knolls Dr., Peoria, IL 61614 | Registered Nurse | 2005-11-15 ~ 2006-04-30 |
| Rochell De Guzman Meneses | 3120 W Willow Knolls Dr Apt 204, Peoria, IL 61614-1013 | Physical Therapist | 2014-04-01 ~ 2015-03-31 |
| Find all Licenses in zip 61614 | |||
| City | Peoria |
| Zip Code | 61614 |
| License Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| License Type + County | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER + Peoria |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Imran Hafeez | 176 Windridge Rd, Valparaiso, IN 46385-6053 | Controlled Substance Registration for Practitioner | 2017-04-05 ~ 2019-02-28 |
| Imran R Ally | 24 Hospital Ave, Danbury, CT 06810-6099 | Controlled Substance Registration for Practitioner | 2013-03-01 ~ 2015-02-28 |
| Imran Alkhalil | 375 Congress Ave Lsog 120, New Haven, CT 06519-1404 | Controlled Substance Registration for Practitioner | 2015-03-01 ~ 2017-02-28 |
| Imran Siddiqui | 1450 Chapel St # 136, New Haven, CT 06511-4405 | Controlled Substance Registration for Practitioner | 2009-03-01 ~ 2011-02-28 |
| Imran Baig | 400 Burr Street, New Haven, CT 06512 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Imran S Sheikh | 64 Robbins St # 3304, Waterbury, CT 06708-2613 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Imran A Jamil | 2800 Main St, Bridgeport, CT 06606-4201 | Controlled Substance Registration for Practitioner | 2015-03-01 ~ 2017-02-28 |
| Imran Anwar Pasha Siddiqui | 74 Westwood Rd, Fairfield, CT 06825-1659 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Imran Samad Qureshi | 379 W Pleasantview Avenue, Hackensack, NJ 07601 | Controlled Substance Registration for Practitioner | 2017-11-20 ~ 2019-02-28 |
| Mahnoor Imran | C/o 20 York St., Tompkins 2, Room 226, New Haven, CT 06510 | Controlled Substance Registration for Practitioner | 2019-06-05 ~ 2021-02-28 |
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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).