EVAN JOHNSON (Credential# 1024649) is licensed (Controlled Substance Registration for Practitioner) with Connecticut Department of Consumer Protection. The license effective date is August 12, 2011. The license expiration date date is February 28, 2013. The license status is INACTIVE.
EVAN JOHNSON is licensed with the Department of Consumer Protection of Connecticut. The credential number is #CSP.0050920. The credential type is controlled substance registration for practitioner. The effective date is August 12, 2011. The expiration date is February 28, 2013. The business address is 263 Farmington Ave # Mc-3955, Farmington, CT 06030-0002. The current status is inactive.
| Licensee Name | EVAN JOHNSON |
| Credential ID | 1024649 |
| Credential Number | CSP.0050920 |
| Credential Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| Business Address |
263 Farmington Ave # Mc-3955 Farmington CT 06030-0002 |
| Business Type | INDIVIDUAL |
| Status | INACTIVE |
| Issue Date | 2011-08-12 |
| Effective Date | 2011-08-12 |
| Expiration Date | 2013-02-28 |
| Refresh Date | 2014-07-24 |
| Street Address | 263 FARMINGTON AVE # MC-3955 |
| City | FARMINGTON |
| State | CT |
| Zip Code | 06030-0002 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Nicole Goulet | 263 Farmington Ave # Mc-3955, Farmington, CT 06030-0002 | Controlled Substance Registration for Practitioner | 2015-03-01 ~ 2017-02-28 |
| Benjamin Schmidt | 263 Farmington Ave # Mc-3955, Farmington, CT 06030-0002 | Controlled Substance Registration for Practitioner | 2015-03-01 ~ 2017-02-28 |
| Michael Hagar | 263 Farmington Ave # Mc-3955, Farmington, CT 06030-0002 | Controlled Substance Registration for Practitioner | 2013-03-15 ~ 2015-02-28 |
| Stephanie M Rubino | 263 Farmington Ave # Mc-3955, Farmington, CT 06030-0002 | Controlled Substance Registration for Practitioner | 2013-03-01 ~ 2015-02-28 |
| Tina Thomas | 263 Farmington Ave # Mc-3955, Farmington, CT 06030-0002 | Controlled Substance Registration for Practitioner | 2013-03-25 ~ 2015-02-28 |
| Hoyt Doak Iv | 263 Farmington Ave # Mc-3955, Farmington, CT 06030-0002 | Controlled Substance Registration for Practitioner | 2013-03-01 ~ 2015-02-28 |
| Syed Razi | 263 Farmington Ave # Mc-3955, Farmington, CT 06030-0002 | Controlled Substance Registration for Practitioner | 2011-07-27 ~ 2013-02-28 |
| Leonard Copertino | 263 Farmington Ave # Mc-3955, Farmington, CT 06030-0001 | Controlled Substance Registration for Practitioner | 2011-11-15 ~ 2013-02-28 |
| Paul Anthony Del Prado | 263 Farmington Ave # Mc-3955, Farmington, CT 06030-0001 | Controlled Substance Registration for Practitioner | 2011-11-22 ~ 2013-02-28 |
| David T Luyimbazi | 263 Farmington Ave # Mc-3955, Farmington, CT 06030-0002 | Controlled Substance Registration for Practitioner | 2011-11-03 ~ 2013-02-28 |
| Find all Licenses in the same address | |||
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Kimberly Henderson | 263 Farmington Ave # Mc2947, Farmington, CT 06030-0002 | Controlled Substance Registration for Practitioner | 2015-03-01 ~ 2017-02-28 |
| Annabelle Rae B Chua | 263 Farmington Ave # Mc-1234, Farmington, CT 06030-0002 | Controlled Substance Registration for Practitioner | 2015-03-01 ~ 2017-02-28 |
| Robert Stewart | 263 Farmington Ave # Mc1234, Farmington, CT 06030-0002 | Controlled Substance Registration for Practitioner | 2013-03-11 ~ 2015-02-28 |
| Mohamed Swedeh | 263 Farmington Ave # Mc1321, Farmington, CT 06030-0002 | Controlled Substance Registration for Practitioner | 2013-03-01 ~ 2015-02-28 |
| Veronica L Tucker | 263 Farmington Ave # Mc1930, Farmington, CT 06030-0002 | Controlled Substance Registration for Practitioner | 2013-03-01 ~ 2015-02-28 |
| Dhruva Chawla | 263 Farmington Ave # Mc-1235, Farmington, CT 06030-0002 | Controlled Substance Registration for Practitioner | 2013-04-03 ~ 2015-02-28 |
| Rahul Patel | 263 Farmington Ave # Mc-1930, Farmington, CT 06030-0002 | Controlled Substance Registration for Practitioner | 2013-03-06 ~ 2015-02-28 |
| Algenon Parson | 263 Farmington Ave # Mc-2015, Farmington, CT 06030-0002 | Controlled Substance Registration for Practitioner | 2013-03-07 ~ 2015-02-28 |
| Cory Edgar | 263 Farmington Ave # Mc-4037, Farmington, CT 06030-0002 | Controlled Substance Registration for Practitioner | 2013-03-01 ~ 2015-02-28 |
| Richard Shamo | 263 Farmington Ave # Mc-1720, Farmington, CT 06030-0002 | Controlled Substance Registration for Practitioner | 2013-03-01 ~ 2015-02-28 |
| Find all Licenses in zip 06030-0002 | |||
| 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 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| License Type + County | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER + FARMINGTON |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Evan P Provisor | Fiskdale, MA 01518-1043 | Controlled Substance Registration for Practitioner | 2009-03-01 ~ 2011-02-28 |
| Evan Fox | 300 Hebron Ave Ste 107, Glastonbury, CT 06033 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Evan J Burke | 100 Retreat Ave, Hartford, CT 06106 | Controlled Substance Registration for Practitioner | 2019-04-01 ~ 2021-02-28 |
| Evan W Jones | 475 Main St Apt 4l, New York, NY 10044-0087 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Evan J Fertig | 12 Doren Ave, Hamden, CT 06517 | Controlled Substance Registration for Practitioner | 2008-03-01 ~ 2009-02-28 |
| Evan Woodford | 24 Hospital Ave, Danbury, CT 06810-6099 | Controlled Substance Registration for Practitioner | 2019-05-09 ~ 2021-02-28 |
| Evan H Lee | 4209 163rd St Fl 2, Flushing, NY 11358-2617 | Controlled Substance Registration for Practitioner | 2017-08-03 ~ 2019-02-28 |
| George Seddon Dds | 108 Evan Rd, Southington, CT 06489 | Controlled Substance Registration for Practitioner | 2003-03-01 ~ 2004-02-28 |
| Evan Michael Vitiello | 34 Park St, New Haven, CT 06519-1109 | Controlled Substance Registration for Practitioner | 2020-06-10 ~ 2021-02-28 |
| Evan Vosburgh Md | 54 Morningside Drive, New York, NY 10025 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
Please comment or provide details below to improve the information on EVAN JOHNSON.
| 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).