LOAN T PHAN (Credential# 1145378) 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.
LOAN T PHAN is licensed with the Department of Consumer Protection of Connecticut. The credential number is #CSP.0054131. 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 12 Donna Rd, Worcester, MA 01609-1145. The current status is active.
| Licensee Name | LOAN T PHAN |
| Credential ID | 1145378 |
| Credential Number | CSP.0054131 |
| Credential Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| Business Address |
12 Donna Rd Worcester MA 01609-1145 |
| Business Type | INDIVIDUAL |
| Status | ACTIVE - CURRENT |
| Active | 1 |
| Issue Date | 2013-03-18 |
| Effective Date | 2019-03-01 |
| Expiration Date | 2021-02-28 |
| Refresh Date | 2019-02-28 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 742783 | 23.001034 | Physician Assistant | 2000-11-29 | 2019-09-01 - 2020-08-31 | ACTIVE |
| 261156 | CSP.0030439 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 2001-01-16 - 2002-02-28 | INACTIVE |
| Street Address | 12 DONNA RD |
| City | WORCESTER |
| State | MA |
| Zip Code | 01609-1145 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Steven L Berk Md | 8 Donna Rd, Worcester, MA 01609-1145 | Physician/surgeon | 2016-06-01 ~ 2017-05-31 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Phuc Hong Tran | 81 Russell Street Apt#3, Worcester, MA 01609 | Nail Technician | ~ |
| Ruben Peralta | 2 Brookshire Rd, Worcester, MA 01609 | Physician/surgeon | 2020-06-01 ~ 2021-05-31 |
| Dominic J Nompleggi Md | 7 Aylebury Road, Worcester, MA 01609 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Mavis Amankwah | 11 Sever Street, Worcester, MA 01609 | Advanced Practice Registered Nurse | ~ |
| Celena E Adjei | 48 Carter Rd, Worcester, MA 01609 | Pharmacist | 2020-02-01 ~ 2022-01-31 |
| Cheryl A Knowlton | 80 Forest Street, Worcester, MA 01609 | Registered Nurse | 2020-01-01 ~ 2020-12-31 |
| Whitney J Parker | 32 Montclair Dr, Worcester, MA 01609 | Professional Engineer | 2020-02-01 ~ 2021-01-31 |
| Diana Rehnuma Lasker | 18 Ashland St Apt 1r, Worcester, MA 01609 | Pharmacy Intern | 2019-10-03 ~ 2020-09-30 |
| Four Trees Management, Co. | 30 Somerset Street, Worcester, MA 01609 | Securities - Exemptions | 2019-09-17 ~ |
| Margarita C Menocal | 6 Surray Lane, Worcester, MA 01609 | Physical Therapist | 2018-04-01 ~ 2019-03-31 |
| Find all Licenses in zip 01609 | |||
| City | WORCESTER |
| Zip Code | 01609 |
| License Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| License Type + County | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER + WORCESTER |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Hy V Phan Md | 23 Barnett St C22, New Haven, CT 06515 | Controlled Substance Registration for Practitioner | 2013-05-07 ~ 2015-02-28 |
| Tuong-vi Phan | 40 Prospect Ave Bld 2 Apt 1k, Norwalk, CT 06850 | Controlled Substance Registration for Practitioner | 2013-03-01 ~ 2015-02-28 |
| Alexander F Phan | 25 Palmetto Dr Apt F, Alhambra, CA 91801-5906 | Controlled Substance Registration for Practitioner | 2013-08-16 ~ 2015-02-28 |
| Andrew S Phan | 2800 Main St Level 3 Dept of Medicine, Bridgeport, CT 06606 | Controlled Substance Registration for Practitioner | 2017-06-19 ~ 2019-02-28 |
| Thi Loan Phan | 357 Court D Bldg 49, Bridgeport, CT 06610 | Combination Nail Technician, Esthetician Or Eyelash Technici | 2020-05-21 ~ 2022-02-28 |
| Loan Semillon | Connecticut Brand Registration, Hartford, CT 06106 | Liquor Brand Label | 2007-09-06 ~ 2010-09-05 |
| Loan Shiraz | Connecticut Brand Registration, Hartford, CT 06106 | Liquor Brand Label | 2007-09-06 ~ 2010-09-05 |
| Loan Raven's Rose | Connecticut Brand Registration, Hartford, CT 06106 | Liquor Brand Label | 2008-08-12 ~ 2011-08-11 |
| Ez Money Jewelry and Loan | 2188 Berlin Tpke, Newington, CT 06111-3210 | Operator of Weighing & Measuring Devices | 2019-08-01 ~ 2020-07-31 |
| Steven Kassels Md · Community Substance Abuse Center | Comm. Physicians PC/125 North Elm Street, Westfield, MA 01085 | Controlled Substance Registration for Practitioner | 2018-06-15 ~ 2019-02-28 |
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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).