KELLY M FERJENTSIK (Credential# 1080123) 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.
KELLY M FERJENTSIK is licensed with the Department of Consumer Protection of Connecticut. The credential number is #CSP.0052813. 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 34 Little Fox Ln, Monroe, CT 06468-1607. The current status is active.
| Licensee Name | KELLY M FERJENTSIK |
| Credential ID | 1080123 |
| Credential Number | CSP.0052813 |
| Credential Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| Business Address |
34 Little Fox Ln Monroe CT 06468-1607 |
| Business Type | INDIVIDUAL |
| Status | ACTIVE - CURRENT |
| Active | 1 |
| Issue Date | 2012-07-03 |
| Effective Date | 2019-03-01 |
| Expiration Date | 2021-02-28 |
| Refresh Date | 2019-01-25 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 1066525 | 3.002854 | Optometrist | 2012-06-11 | 2019-11-01 - 2020-10-31 | ACTIVE |
| Street Address | 34 LITTLE FOX LN |
| City | MONROE |
| State | CT |
| Zip Code | 06468-1607 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Liliya Maklyan | 31 Pastors Walk, Monroe, CT 06468 | Esthetician | ~ |
| Marion K Becker | 54 Greenwood Drive, Monroe, CT 06468 | Licensed Practical Nurse | 2020-09-01 ~ 2021-08-31 |
| Valerie Matte-zabin | 139 Bart Rd, Monroe, CT 06468 | Hairdresser/cosmetician | 2020-09-01 ~ 2022-08-31 |
| Hang T Dang | 150 Main St, Monroe, CT 06468 | Combination Nail Technician, Esthetician Or Eyelash Technici | 2020-06-26 ~ 2022-06-30 |
| Leanne M Grace | 79 Pastors Walk, Monroe, CT 06468 | Hairdresser/cosmetician | 2020-09-01 ~ 2022-08-31 |
| Alicia Marie Walker | 12 Edgewood Road, Monroe, CT 06468 | Registered Nurse | 2020-08-01 ~ 2021-07-31 |
| Trina Duong | 202f Windgate Cir, Monroe, CT 06468 | Nail Technician | ~ |
| Julie M Boardman | 95 Richards Drive, Monroe, CT 06468 | Registered Nurse | 2020-06-01 ~ 2021-05-31 |
| Marilia Curral Giacobbe | 260 Cutlers Farm Road, Monroe, CT 06468 | Notary Public Appointment | 2015-03-01 ~ 2020-02-28 |
| Jane E Allen · Eschweiler | 3 Timber Dr, Monroe, CT 06468 | Registered Nurse | 2020-08-01 ~ 2021-07-31 |
| Find all Licenses in zip 06468 | |||
| City | MONROE |
| Zip Code | 06468 |
| License Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| License Type + County | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER + MONROE |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Kelly M. Doran Md | New Haven, CT 06511 | Controlled Substance Registration for Practitioner | 2013-03-01 ~ 2015-02-28 |
| Kelly J Way | 34 B Springbrook Rd, Westerly, RI 02891 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Kelly Gullotta | Po Box 465, Brownsville, VT 05037-0465 | Controlled Substance Registration for Practitioner | 2020-04-09 ~ 2021-02-28 |
| Kelly M Deforest | 267 Rte 87, Columbia, CT 06237 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Barbara A Kelly Md | 6 Stonewood Dr, Old Lyme, CT 06371 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Erin Kelly Walsh | 20 W End, Old Greenwich, CT 06870 | Controlled Substance Registration for Practitioner | 2020-06-25 ~ 2021-02-28 |
| Kelly E Baxter | 96 W Shannock Rd, Richmond, RI 02812-1145 | Controlled Substance Registration for Practitioner | 2020-02-24 ~ 2021-02-28 |
| Kelly Davis | 267 Grant St, Bridgeport, CT 06610-2805 | Controlled Substance Registration for Practitioner | 2017-03-01 ~ 2019-02-28 |
| Syed S A Hasni Md | 24 Kelly Dr, Marlton, NJ 08053-9701 | Controlled Substance Registration for Practitioner | 2011-03-07 ~ 2013-02-28 |
| Sonya Lee Kelly Md | 106 Strickland Rd, Middlefield, CT 06455 | 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).