JAMEY L BURRIS-FISH (Credential# 1212735) is licensed (Controlled Substance Registration for Practitioner) with Connecticut Department of Consumer Protection. The license effective date is March 1, 2017. The license expiration date date is February 28, 2019. The license status is LAPSED.
JAMEY L BURRIS-FISH is licensed with the Department of Consumer Protection of Connecticut. The credential number is #CSP.0056881. The credential type is controlled substance registration for practitioner. The effective date is March 1, 2017. The expiration date is February 28, 2019. The business address is 11820 Sw Bruce Dr, Beaverton, OR 97008-8587. The current status is lapsed.
| Licensee Name | JAMEY L BURRIS-FISH |
| Credential ID | 1212735 |
| Credential Number | CSP.0056881 |
| Credential Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| Business Address |
11820 Sw Bruce Dr Beaverton OR 97008-8587 |
| Business Type | INDIVIDUAL |
| Status | LAPSED |
| Active | 1 |
| Issue Date | 2014-03-20 |
| Effective Date | 2017-03-01 |
| Expiration Date | 2019-02-28 |
| Refresh Date | 2019-03-06 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 1207569 | 10.117700 | Registered Nurse | 2014-03-19 | 2017-12-01 - 2018-11-30 | INACTIVE |
| 1207578 | 12.005709 | Advanced Practice Registered Nurse | 2014-03-19 | 2017-12-01 - 2018-11-30 | INACTIVE |
| Street Address | 11820 SW BRUCE DR |
| City | BEAVERTON |
| State | OR |
| Zip Code | 97008-8587 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Vello A Koiv | 8285 Sw Nimbus Ave, Beaverton, OR 97008 | Professional Engineer | 2020-02-01 ~ 2021-01-31 |
| Ilje E Allsup | 13785 Sw Otter Lane, Beaverton, OR 97008 | Registered Nurse | 2004-08-05 ~ 2005-09-30 |
| Walgreens Mail Service | 9775 Sw Gemini Drive, Beaverton, OR 97008 | Nonresident Pharmacy | 2007-09-01 ~ 2008-08-31 |
| Indio Spirits Inc · Indio Spirits | 8229 Sw Cirrus Dr, Beaverton, OR 97008-5992 | Out of State Shipper Liquor | 2011-08-12 ~ 2012-08-11 |
| Kaire Kalam | 9450 Sw Gemini Dr # 10655, Beaverton, OR 97008-7105 | Massage Therapist | 2018-10-01 ~ 2020-09-30 |
| Walgreens Specialty Pharmacy LLC · Alliancerx Walgreens Prime #12314 | 9775 Sw Gemini Dr Ste 1, Beaverton, OR 97008-7148 | Nonresident Pharmacy | 2019-09-01 ~ 2020-08-31 |
| Smith Monroe Gray Engineers Inc | 8625 Sw Cascade Ave Ste 600, Beaverton, OR 97008-7199 | Professional Engineering Corporation | 2018-04-13 ~ 2019-04-12 |
| Jennifer J Veldorale-brogan | 9925 Sw Nimbus Ave Ste 110, Beaverton, OR 97008-7592 | Professional Engineer | 2020-02-01 ~ 2021-01-31 |
| John Fredrick Bradford | 9925 S W Nimbus Ave Ste 110, Beaverton, OR 97008-7592 | Professional Engineer | 2008-02-01 ~ 2009-01-31 |
| Michael D Redmond | 11705 Sw Robbins Dr, Beaverton, OR 97008-7949 | Professional Engineer | 2020-02-01 ~ 2021-01-31 |
| Find all Licenses in zip 97008 | |||
| City | BEAVERTON |
| Zip Code | 97008 |
| License Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| License Type + County | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER + BEAVERTON |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Heather H Burris Md | 330 Brookline Ave, Ro 318, Bld Mc Neo, Boston, MA 02215 | Controlled Substance Registration for Practitioner | 2013-03-01 ~ 2015-02-28 |
| James E Burris Md | 261 Legend Hill Rd, Madison, CT 06443-1881 | Controlled Substance Registration for Practitioner | 2013-03-01 ~ 2015-02-28 |
| John O Burris Md | 39 High Ridge Rd, Redding, CT 06896 | Controlled Substance Registration for Practitioner | 1996-07-02 ~ 1997-02-28 |
| Harriet Burris Md | Middlesex Medical Ctr, Essex, CT 06426 | Controlled Substance Registration for Practitioner | 2006-03-01 ~ 2007-02-28 |
| Guy L Fish Md | St. Mary's Hospital, Waterbury, CT 06702 | Controlled Substance Registration for Practitioner | 1997-03-01 ~ 1998-02-28 |
| Bernard G Fish | 67 Sand Pit Rd Ste 204, Danbury, CT 06810-4032 | Controlled Substance Registration for Practitioner | 2017-03-01 ~ 2019-02-28 |
| Daniel N Fish | 60 Old New Milford Rd, Brookfield, CT 06804 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Cheryl W Anderson | 700 Fish Rock Rd, Southbury, CT 06488-4149 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Scott T Schmidt Md | 949 Fish Hill Rd, Coventry, RI 02816-4715 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Robert H Fish | 945 Main Street, Manchester, CT 06040 | Controlled Substance Registration for Practitioner | 2015-03-01 ~ 2017-02-28 |
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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).