LISA M BERGERON Miss (Credential# 1052218) 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.
LISA M BERGERON Miss is licensed with the Department of Consumer Protection of Connecticut. The credential number is #CSP.0051984. 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 69 Chittenden Rd, Killingworth, CT 06419. The current status is active.
| Licensee Name | LISA M BERGERON Miss |
| Credential ID | 1052218 |
| Credential Number | CSP.0051984 |
| Credential Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| Business Address |
69 Chittenden Rd Killingworth CT 06419 |
| Business Type | INDIVIDUAL |
| Status | ACTIVE - CURRENT |
| Active | 1 |
| Issue Date | 2012-02-24 |
| Effective Date | 2019-03-01 |
| Expiration Date | 2021-02-28 |
| Refresh Date | 2018-12-28 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 1048923 | 12.004923 | Advanced Practice Registered Nurse | 2012-01-24 | 2019-12-01 - 2020-11-30 | ACTIVE |
| 1049320 | 10.104009 | Registered Nurse | 2012-01-24 | 2019-12-01 - 2020-11-30 | ACTIVE |
| Street Address | 69 chittenden rd |
| City | killingworth |
| State | CT |
| Zip Code | 06419 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Rajendra K Bobba | 39 Buell Hill Rd, Killingworth, CT 06419 | Physician/surgeon | 2020-09-01 ~ 2021-08-31 |
| Deborah M Cabral | 61 Little Cty Rd, Killingworth, CT 06419 | Registered Nurse | 2020-07-01 ~ 2021-06-30 |
| Cheryl Dickson Toman | 16 Cedar Drive, Killingworth, CT 06419 | Notary Public Appointment | 2020-07-01 ~ 2025-06-30 |
| Nanci S Coleman | 9 Buell Hill Rd., Killingworth, CT 06419 | Registered Nurse | 2020-07-01 ~ 2021-06-30 |
| Sondra D Arbona | 21 Robin Ln, Killingworth, CT 06419 | Registered Nurse | 2020-08-01 ~ 2021-07-31 |
| Lisa R Barbour | 32 Boulder Trail, Killingworth, CT 06419 | Notary Public Appointment | 2020-10-01 ~ 2025-09-30 |
| Barbara K Irzyk | 12 Warwickshire Dr., Killingworth, CT 06419 | Speech and Language Pathologist | 2020-09-01 ~ 2021-08-31 |
| Diane Shauk Shuir | 184 Route 81 Bldg2, Killingworth, CT 06419 | Combination Nail Technician, Esthetician Or Eyelash Technici | 2020-06-20 ~ 2022-05-31 |
| Yvonne Bradley | 42 Fawn Hill Road, Killingworth, CT 06419 | Licensed Clinical Social Worker | 2020-09-01 ~ 2021-08-31 |
| Staci L Petroskey | 140 Little City Road, Killingworth, CT 06419 | Registered Nurse | 2020-07-01 ~ 2021-06-30 |
| Find all Licenses in zip 06419 | |||
| City | killingworth |
| Zip Code | 06419 |
| License Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| License Type + County | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER + killingworth |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Francine M Minor | 4132 Ole Miss Drive, Kenner, LA 70065 | Controlled Substance Registration for Practitioner | 2007-03-01 ~ 2008-02-29 |
| Miss Lisa's Montessori | 53 Quarry Road, Simsbury, CT 06070 | Child Care Center | 2005-09-29 ~ |
| Miss Lisa's Montessori School | 540 Hopmeadow, Simsbury, CT 06070 | Child Care Center | 2014-04-01 ~ 2018-03-31 |
| Lisa Phuong | 440 W End Ave Apt 12f, New York, NY 10024-5358 | Controlled Substance Registration for Practitioner | 2017-03-01 ~ 2019-02-28 |
| Lisa M Fox | 50 Woodland Dr, Northford, CT 06472-1206 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Lisa Kim | 56 Franklin St, Waterbury, CT 06706-1253 | Controlled Substance Registration for Practitioner | 2015-04-23 ~ 2017-02-28 |
| Lisa K Yoo Do | 121 Gower Rd, New Canaan, CT 06840 | Controlled Substance Registration for Practitioner | 2017-03-01 ~ 2019-02-28 |
| Lisa J Mao | 49 Lake Ave, Greenwich, CT 06830-4501 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Lisa D Picascia | Middletown, CT 06457 | Controlled Substance Registration for Practitioner | 2018-04-04 ~ 2019-02-28 |
| Lisa J Boucher | 60 Lane St, Shelton, CT 06484-5225 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
Please comment or provide details below to improve the information on LISA M BERGERON Miss.
| 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).