ANNA M BROCK (Credential# 1038506) 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.
ANNA M BROCK is licensed with the Department of Consumer Protection of Connecticut. The credential number is #CSP.0051593. 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 Po Box 793, Middletown, CT 06457. The current status is active.
| Licensee Name | ANNA M BROCK |
| Credential ID | 1038506 |
| Credential Number | CSP.0051593 |
| Credential Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| Business Address |
Po Box 793 Middletown CT 06457 |
| Business Type | INDIVIDUAL |
| Status | ACTIVE - CURRENT |
| Active | 1 |
| Issue Date | 2011-10-27 |
| Effective Date | 2019-03-01 |
| Expiration Date | 2021-02-28 |
| Refresh Date | 2019-02-13 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 584041 | 10.080039 | Registered Nurse | 2006-09-26 | 2019-08-01 - 2020-07-31 | ACTIVE |
| 980807 | 12.004629 | Advanced Practice Registered Nurse | 2011-03-23 | 2019-08-01 - 2020-07-31 | ACTIVE |
| Street Address | PO Box 793 |
| City | Middletown |
| State | CT |
| Zip Code | 06457 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Elizabeth M Mailhot | 177 Timber Ridge Rd, Middletown, CT 06457 | Dental Hygienist | 2020-08-01 ~ 2021-07-31 |
| Rebecca S Fennessy | 22 Keefe Ln, Middletown, CT 06457 | Licensed Clinical Social Worker | 2020-07-01 ~ 2021-06-30 |
| Eloise M Gagnon | 538 Bow Lane, Middletown, CT 06457 | Hairdresser/cosmetician | 2020-08-01 ~ 2022-07-31 |
| Salvatore Dimauro | 245 Dekoven Dr, Middletown, CT 06457 | Public Weigher | 2020-07-01 ~ 2021-06-30 |
| Frank L Wright | 261 Spencer Dr, Middletown, CT 06457 | Barber | 2020-08-01 ~ 2022-07-31 |
| Gino A Cardella | 50 Sonoma Lane, Middletown, CT 06457 | Real Estate Salesperson | ~ |
| Shannon Lee Mcquillan | 5 Forest Glen Circle, Middletown, CT 06457 | Registered Nurse | 2020-06-26 ~ 2020-09-30 |
| Lori Dimauro · Carta | 244 Chamberlain Hill Road, Middletown, CT 06457 | Hairdresser/cosmetician | 2020-09-01 ~ 2022-08-31 |
| Gail A Corrow | 85 Dora Dr, Middletown, CT 06457 | Real Estate Salesperson | 2020-06-01 ~ 2021-05-31 |
| Mariter V Perez | 8 Moss Glen, Middletown, CT 06457 | Registered Nurse | 2020-08-01 ~ 2021-07-31 |
| Find all Licenses in zip 06457 | |||
| City | Middletown |
| Zip Code | 06457 |
| License Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| License Type + County | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER + Middletown |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Brock Drapkin | 84 Walpole St, Canton, MA 02021 | Controlled Substance Registration for Practitioner | 2019-02-28 ~ 2021-02-28 |
| Brock F Daniels | 91 Lyon St Apt 1, New Haven, CT 06511-4925 | Controlled Substance Registration for Practitioner | 2015-03-01 ~ 2017-02-28 |
| Dana Brock Md | 160 Tokeneke Dr, N Haven, CT 06473 | Controlled Substance Registration for Practitioner | 1994-08-17 ~ 1996-07-01 |
| Mary G Brock · Guion | 385 W Main St, Avon, CT 06001-4357 | Controlled Substance Registration for Practitioner | 2019-05-17 ~ 2021-02-28 |
| Mary M Kane-brock Md | 71 Dandy Drive, Cos Cob, CT 06807 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Dana Brock | 38 Orchard Court, Hamden, CT 06517 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Anna Karidas Dds | 15 Lighthouse Way, Stamford, CT 06902 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Anna Sharovetskaya | 130 Division St, Derby, CT 06418-1326 | Controlled Substance Registration for Practitioner | 2015-07-15 ~ 2017-02-28 |
| Anna P Ziganshina | 111 Park St Apt 17b, New Haven, CT 06511-5470 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Anna Komnatnaya | 360 State St Apt 809, New Haven, CT 06510-3604 | 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).