JIGNESH M MODI (Credential# 1168922) 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.
JIGNESH M MODI is licensed with the Department of Consumer Protection of Connecticut. The credential number is #CSP.0054873. 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 3 Twin Pines Dr, Wallingford, CT 06492-6020. The current status is active.
| Licensee Name | JIGNESH M MODI |
| Credential ID | 1168922 |
| Credential Number | CSP.0054873 |
| Credential Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| Business Address |
3 Twin Pines Dr Wallingford CT 06492-6020 |
| Business Type | INDIVIDUAL |
| Status | ACTIVE - CURRENT |
| Active | 1 |
| Issue Date | 2013-06-13 |
| Effective Date | 2019-03-01 |
| Expiration Date | 2021-02-28 |
| Refresh Date | 2019-01-17 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 1118675 | 1.051427 | Physician/Surgeon | 2012-09-25 | 2020-02-01 - 2021-01-31 | ACTIVE |
| Street Address | 3 TWIN PINES DR |
| City | WALLINGFORD |
| State | CT |
| Zip Code | 06492-6020 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Krupa Modi | 3 Twin Pines Dr, Wallingford, CT 06492-6020 | Registered Nurse | 2019-08-01 ~ 2020-07-31 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Guoping Cai | 21 Twin Pines Dr, Wallingford, CT 06492-6020 | Physician/surgeon | 2020-08-01 ~ 2021-07-31 |
| Sarah E Baxter | 27 Twin Pines Dr, Wallingford, CT 06492-6020 | Registered Nurse | 2020-07-01 ~ 2021-06-30 |
| Tasha Cook-pye | 45 Twin Pines Dr, Wallingford, CT 06492-6020 | Esthetician | 2020-03-04 ~ 2021-07-31 |
| Gerald Chuong | 19 Twin Pines Dr, Wallingford, CT 06492-6020 | Pharmacy Intern | 2017-08-23 ~ 2021-09-30 |
| Dean R Baxter | 27 Twin Pines Dr, Wallingford, CT 06492-6020 | Respiratory Care Practitioner | 2020-05-01 ~ 2021-04-30 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Andrea Zola | 53 Alison Ave., Wallingford, CT 06492 | Esthetician | ~ |
| Kyungok Choi | 90 Ward St, Wallingford, CT 06492 | Combination Nail Technician, Esthetician Or Eyelash Technici | ~ |
| Giang Nguyen | 45 Country Club Lane, Wallingford, CT 06492 | Combination Nail Technician, Esthetician Or Eyelash Technici | 2020-06-27 ~ 2021-11-30 |
| Lc Artistry | 207 North Colony Road, Wallingford, CT 06492 | Esthetician | ~ |
| Katie Lee | 20 Angela Dr, Wallingford, CT 06492 | Paramedic | 2020-09-01 ~ 2021-08-31 |
| Vinny's Deli | 567 Center St, Wallingford, CT 06492 | Operator of Weighing & Measuring Devices | 2020-08-01 ~ 2021-07-31 |
| Michele Ruggiero | 26 Leigus Road, Wallingford, CT 06492 | Radiographer | 2020-07-01 ~ 2021-06-30 |
| Dianna K Ball | 104 Simpson Ave, Wallingford, CT 06492 | Speech and Language Pathologist | 2020-08-01 ~ 2021-07-31 |
| Ann Marie Richardson | 20 Mohawk Drive, Wallingford, CT 06492 | Registered Nurse | 2020-07-01 ~ 2021-06-30 |
| Joann Hummel | 60 Deer Run Road, Wallingford, CT 06492 | Medication Administration Certification | 2018-08-21 ~ 2020-08-20 |
| Find all Licenses in zip 06492 | |||
| City | WALLINGFORD |
| Zip Code | 06492 |
| License Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| License Type + County | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER + WALLINGFORD |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Aparna K Modi | 430 W Putnam Ave, Greenwich, CT 06830-6244 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Viraj I Modi | 100 Grand St, New Britain, CT 06052-2016 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Sachin Modi | 2 Peaceful Ln, Norwalk, CT 06851-3404 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Nishit R Modi Dds | 685 Queen St Ste 3, Southington, CT 06489-1547 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| 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 |
| Shu-i Lin | CT | Controlled Substance Registration for Practitioner | 2017-06-12 ~ 2019-02-28 |
| Erin K Fee | CT | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Arundati Rao | CT | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Hae J Kim Pa | New Haven, CT 06511 | Controlled Substance Registration for Practitioner | 2008-03-31 ~ 2009-02-28 |
| Qi Che Md | Bridgeport, CT 06610 | Controlled Substance Registration for Practitioner | 2006-03-01 ~ 2007-02-28 |
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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).