MARK S LARSEN (Credential# 1027484) 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.
MARK S LARSEN is licensed with the Department of Consumer Protection of Connecticut. The credential number is #CSP.0051159. 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 160 Shadbush Dr, Colchester, CT 06415. The current status is active.
| Licensee Name | MARK S LARSEN |
| Credential ID | 1027484 |
| Credential Number | CSP.0051159 |
| Credential Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| Business Address |
160 Shadbush Dr Colchester CT 06415 |
| Business Type | INDIVIDUAL |
| Status | ACTIVE - CURRENT |
| Active | 1 |
| Issue Date | 2011-08-05 |
| Effective Date | 2019-03-01 |
| Expiration Date | 2021-02-28 |
| Refresh Date | 2019-01-25 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 679948 | 12.001769 | Advanced Practice Registered Nurse | 1998-02-06 | 2020-02-01 - 2021-01-31 | ACTIVE |
| 615356 | 10.E45578 | Registered Nurse | 1983-03-17 | 2020-02-01 - 2021-01-31 | ACTIVE |
| 283965 | CSP.0031381 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 2005-03-01 | 2008-03-01 - 2009-02-28 | INACTIVE |
| 194602 | CSP.0026628 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 1998-03-18 - 1999-02-28 | INACTIVE |
| Street Address | 160 SHADBUSH DR |
| City | COLCHESTER |
| State | CT |
| Zip Code | 06415 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Ashley Shattuck | 66 South Road, Colchester, CT 06415 | Licensed Clinical Social Worker | 2020-07-01 ~ 2021-06-30 |
| Linda Smith · Lamb | 25 Loomis Road, Colchester, CT 06415 | Hairdresser/cosmetician | 2020-09-01 ~ 2022-08-31 |
| Vincent Vespa Jr | 671 Norwich Ave, Colchester, CT 06415 | Sub-surface Sewage Installer | 2020-09-01 ~ 2021-08-31 |
| Deborah L Strong · Bowen | 98 Lebanon Avenue, Colchester, CT 06415 | Hairdresser/cosmetician | 2020-07-01 ~ 2022-06-30 |
| Lucy A Boisse | 115 Stanavage Road, Colchester, CT 06415 | Hairdresser/cosmetician | 2020-08-01 ~ 2022-07-31 |
| Alicia R Bohnenkamper | 906 Canterbury Lane, Colchester, CT 06415 | Notary Public Appointment | 2011-09-28 ~ 2016-09-30 |
| Anna M Sofia | 75 B Elmwood Heights, Colcheshter, CT 06415 | Registered Nurse | 2020-07-01 ~ 2021-06-30 |
| J J Noels Supermarket | 15 Broadway, Colchester, CT 06415 | Operator of Weighing & Measuring Devices | 2020-08-01 ~ 2021-07-31 |
| Linda S Kvasnik | 69 Colburn Dr, Colchester, CT 06415 | Registered Nurse | 2020-08-01 ~ 2021-07-31 |
| James W Bansemer · General Builders & Remodelers | 87 O'connell Road, Colchester, CT 06415 | Home Improvement Contractor | 2020-06-25 ~ 2020-11-30 |
| Find all Licenses in zip 06415 | |||
| City | COLCHESTER |
| Zip Code | 06415 |
| License Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| License Type + County | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER + COLCHESTER |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Ammon J Larsen | 64 Avonwood Rd Apt A21, Avon, CT 06001-2080 | Controlled Substance Registration for Practitioner | 2017-03-01 ~ 2019-02-28 |
| Mark R Cullen Md | 22 Lee Way, Madison, CT 06443 | Controlled Substance Registration for Practitioner | 2009-03-01 ~ 2011-02-28 |
| Mark P Goldstein Md | 754 E 6th St #5d, New York, NY 10009 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Mark C Lee Md | 282 Washington St, Hartford, CT 06106-3322 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Mark A Venditti | 24 Hospital Ave, Danbury, CT 06810-6099 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Mark Hwang | 5 Perryridge Rd, Greenwich, CT 06830-4608 | Controlled Substance Registration for Practitioner | 2015-05-18 ~ 2017-02-28 |
| Mark Aferzon Md | 2 Ivy Brook Rd Ste 110, Shelton, CT 06484-6416 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Mark H Michalski | 192 Foster St Apt 23, New Haven, CT 06511-2660 | Controlled Substance Registration for Practitioner | 2011-08-16 ~ 2013-02-28 |
| Mark W Greve | 61 Three Corners Rd, Guilford, CT 06437 | Controlled Substance Registration for Practitioner | 2005-04-18 ~ 2006-02-28 |
| Mark Sturgis Od | 29 Buckland St, Manchester, CT 06042-1601 | 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).