AUDREY LASTRA PA-C (Credential# 1025715) is licensed (Controlled Substance Registration for Practitioner) with Connecticut Department of Consumer Protection. The license effective date is March 1, 2019. The license expiration date date is February 28, 2021. The license status is ACTIVE.
AUDREY LASTRA PA-C is licensed with the Department of Consumer Protection of Connecticut. The credential number is #CSP.0051053. The credential type is controlled substance registration for practitioner. The effective date is March 1, 2019. The expiration date is February 28, 2021. The business address is 59 Cypress Rd, Newington, CT 06111-5601. The current status is active.
| Licensee Name | AUDREY LASTRA PA-C |
| Credential ID | 1025715 |
| Credential Number | CSP.0051053 |
| Credential Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| Business Address |
59 Cypress Rd Newington CT 06111-5601 |
| Business Type | INDIVIDUAL |
| Status | ACTIVE - CURRENT |
| Active | 1 |
| Issue Date | 2011-07-28 |
| Effective Date | 2019-03-01 |
| Expiration Date | 2021-02-28 |
| Refresh Date | 2019-02-15 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 1005820 | 23.002593 | Physician Assistant | 2011-07-13 | 2020-01-01 - 2020-12-31 | ACTIVE |
| Street Address | 59 CYPRESS RD |
| City | NEWINGTON |
| State | CT |
| Zip Code | 06111-5601 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Healthy Choice Ct | 73 Cypress Rd, Newington, CT 06111-5601 | Vending Machine Operator | 2018-07-01 ~ 2019-06-30 |
| D'andre Conaway | 85 Cypress Rd, Newington, CT 06111-5601 | Pharmacy Technician | 2020-04-13 ~ 2021-03-31 |
| Donald H Nagel | 69 Cypress Rd, Newington, CT 06111-5601 | Home Improvement Salesperson | 2013-03-05 ~ 2013-11-30 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Anastasya Anisimova | 114 Fox Run Court, Newington, CT 06111 | Registered Nurse | 2020-08-01 ~ 2021-07-31 |
| Karen S Cleaveland | 52 Amidon Ave, Newington, CT 06111 | Registered Nurse | 2020-07-01 ~ 2021-06-30 |
| Leeann R Johnson | 17 Cinnamon Rd, Newington, CT 06111 | Notary Public Appointment | 2020-09-01 ~ 2025-08-31 |
| Isma Mian | 65 Cortland Way, Newington, CT 06111 | Physician/surgeon | ~ |
| Danielle Rocha | 1582 Willard Ave, Newington, CT 06111 | Notary Public Appointment | 2020-06-26 ~ 2025-06-30 |
| Munson's Chocolates | 3157 Berlin Tpke, Newington, CT 06111 | Operator of Weighing & Measuring Devices | 2020-08-01 ~ 2021-07-31 |
| Shandea Edwards | 21 Hartford Ave #14, Newington, CT 06111 | Medication Administration Certification | ~ |
| Hengchao Xiong | 47 Adam Dr, Newington, CT 06111 | Nail Technician | ~ |
| Tuyen Le Phan | 71 Lantern Hill, Newington, CT 06111 | Nail Technician | ~ |
| Smita Parth Dave | 192 Brookside Rd, Newington, CT 06111 | Esthetician | ~ |
| Find all Licenses in zip 06111 | |||
| City | NEWINGTON |
| Zip Code | 06111 |
| License Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| License Type + County | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER + NEWINGTON |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Natalie Lastra | 300 George Street, New Haven, CT 06511 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Audrey S Lefkowitz Md | Po Box 58, Amston, CT 06231-0058 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Audrey L Garrett | 55 Nye Rd Ste 102, Glastonbury, CT 06033-1281 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Audrey L Elliott Dmd | 4 Ichabod Rd, Simsbury, CT 06070 | Controlled Substance Registration for Practitioner | 2004-02-29 ~ 2005-02-28 |
| Audrey C Bregante Aprn | 319 Columbus Ave, Valhalla, NY 10595 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Audrey Chun | 5 Perryridge Road, Greenwich, CT 06830 | Controlled Substance Registration for Practitioner | 2015-05-18 ~ 2017-02-28 |
| Audrey Marsidi | 4 Proctor Dr, West Hartford, CT 06117-2037 | Controlled Substance Registration for Practitioner | 2017-03-01 ~ 2019-02-28 |
| Audrey J Bakanauskas Aprn | 19 Phelps St, Windsor, CT 06075 | Controlled Substance Registration for Practitioner | 2015-03-01 ~ 2017-02-28 |
| Audrey Anne Merriam | 249 Castle Ave, Fairfield, CT 06825 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Audrey Leclerc Aprn | 673 Burnham St, E Hartford, CT 06108 | Controlled Substance Registration for Practitioner | 1993-02-22 ~ 1995-03-01 |
Please comment or provide details below to improve the information on AUDREY LASTRA PA-C.
| 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).