EILEEN C BALLARD MS MD (Credential# 910230) is licensed (Controlled Substance Registration for Practitioner) with Connecticut Department of Consumer Protection. The license effective date is March 1, 2017. The license expiration date date is February 28, 2019. The license status is LAPSED.
EILEEN C BALLARD MS MD is licensed with the Department of Consumer Protection of Connecticut. The credential number is #CSP.0047141. The credential type is controlled substance registration for practitioner. The effective date is March 1, 2017. The expiration date is February 28, 2019. The business address is 1684 Dixwell Ave, Hamden, CT 06514-3111. The current status is lapsed.
| Licensee Name | EILEEN C BALLARD MS MD |
| Credential ID | 910230 |
| Credential Number | CSP.0047141 |
| Credential Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| Business Address |
1684 Dixwell Ave Hamden CT 06514-3111 |
| Business Type | INDIVIDUAL |
| Status | LAPSED |
| Active | 1 |
| Issue Date | 2013-07-22 |
| Effective Date | 2017-03-01 |
| Expiration Date | 2019-02-28 |
| Refresh Date | 2019-03-06 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 548661 | 1.030744 | Physician/Surgeon | 1990-05-04 | 2018-01-01 - 2018-12-31 | INACTIVE |
| Street Address | 1684 DIXWELL AVE |
| City | HAMDEN |
| State | CT |
| Zip Code | 06514-3111 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Ramani D Yapa Md | 1684 Dixwell Ave, Hamden, CT 06514 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Richard R Slater | 1684 Dixwell Ave, Hamden, CT 06514 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Eddie D Jackson · Dixwell Wine & Spirits LLC | 1684 Dixwell Ave, Hamden, CT 06514-3111 | Package Store Liquor | ~ |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Jian Rong Huang · Jasa Asian Cuisine | 1720 Dixwell Ave, Hamden, CT 06514-3111 | Restaurant Liquor | 2019-11-06 ~ 2021-03-05 |
| Rosa Lydia Martinez | 1668 Dixwell Avenue, Hamden, CT 06514-3111 | Speech and Language Pathologist | 2000-07-31 ~ 2001-07-31 |
| Chiao-ying Chang · Szechuan Delight | 1720 Dixwell Ave, Hamden, CT 06514-3111 | Restaurant Liquor | 2013-07-03 ~ 2014-06-24 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Erika Henley | 175 Hightop Circle West, Hamden, CT 06514 | Master's Level Social Worker | 2020-06-01 ~ 2021-05-31 |
| Yunmi Lee | 144 Hill St, Hamden, CT 06514 | Combination Nail Technician, Esthetician Or Eyelash Technici | 2020-06-26 ~ 2022-05-31 |
| Rosa M Gordillo | 155 Gorham Ave, Hamden, CT 06514 | Combination Nail Technician, Esthetician Or Eyelash Technici | ~ |
| Linda C Disbrow | 61 Sherman Lane, Hamden, CT 06514 | Registered Nurse | 2020-09-01 ~ 2021-08-31 |
| Kimberly Marie Fernandes | 660 Mix Ave #1h, Hamden, CT 06514 | Radiographer | 2020-07-01 ~ 2021-06-30 |
| Marie Junie Cyril | 175 Oberlin Road, Hamden, CT 06514 | Registered Nurse | 2020-09-01 ~ 2021-08-31 |
| Erica Weiss | 4 Partridge Crossing, Hamden, CT 06514 | Physician/surgeon | 2020-07-01 ~ 2021-06-30 |
| Kimberly S Traverso | 50 Building Brook Road, Hamden, CT 06514 | Professional Counselor | 2020-08-01 ~ 2021-07-31 |
| Kevin A Guess | 3rd Street, Hamden, CT 06514 | Public Weigher | 2020-06-12 ~ 2021-06-30 |
| Marilyn Pavelus | 389 Gilbert Ave, Hamden, CT 06514 | Registered Nurse | 2020-07-01 ~ 2021-06-30 |
| Find all Licenses in zip 06514 | |||
| City | HAMDEN |
| Zip Code | 06514 |
| License Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| License Type + County | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER + HAMDEN |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Lauren M Iacono | 21 Ballard Ave, Staten Island, NY 10312-2203 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Deanna M Ballard | 95 Locust Ave- Praxair Cancer Center, Danbury, CT 06810-8205 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Eileen Comia | 35 Jolley Dr Ste 102, Bloomfield, CT 06002-3062 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Eileen S Wilentz Dvm | 82 Prospect St, New Hartford, CT 06057 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Eileen F Keane | 374 Grand Ave, New Haven, CT 06513 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Eileen O Jennings | 6 Dickinson Dr, Woodbridge, CT 06525 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Eileen M Bush Od | 360 State Street, New Haven, CT 06510 | Controlled Substance Registration for Practitioner | 2011-03-01 ~ 2013-02-28 |
| Mae Eileen Janiga | 33 Farmingberry Drive, Marion, CT 06444 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Eileen M Dickson | 25 Entry Rd, Hopewell Junction, NY 12533-6046 | Controlled Substance Registration for Practitioner | 2020-05-15 ~ 2021-02-28 |
| Eileen O'donnell Aprn | 345 Montauk Ave, New London, CT 06320 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 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).