KELLY DAVIS (Credential# 1216706) 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.
KELLY DAVIS is licensed with the Department of Consumer Protection of Connecticut. The credential number is #CSP.0056990. 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 267 Grant St, Bridgeport, CT 06610-2805. The current status is lapsed.
| Licensee Name | KELLY DAVIS |
| Credential ID | 1216706 |
| Credential Number | CSP.0056990 |
| Credential Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| Business Address |
267 Grant St Bridgeport CT 06610-2805 |
| Business Type | INDIVIDUAL |
| Status | LAPSED |
| Active | 1 |
| Issue Date | 2015-12-14 |
| Effective Date | 2017-03-01 |
| Expiration Date | 2019-02-28 |
| Refresh Date | 2019-03-06 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 1489232 | 1.058478-RES | Resident Physician | 2017-07-01 | 2017-07-01 - 2018-06-30 | INACTIVE |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Kelly Davis | 69 Woodlawn Circle, East Hartford, CT 06108 | Medication Administration Certification | ~ |
| Street Address | 267 GRANT ST |
| City | BRIDGEPORT |
| State | CT |
| Zip Code | 06610-2805 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Lauren Roth | 267 Grant St, Bridgeport, CT 06610-2805 | Resident Physician | 2020-06-22 ~ 2024-06-30 |
| Madeline Carmain | 267 Grant St, Bridgeport, CT 06610-2805 | Resident Physician | 2020-06-22 ~ 2024-06-30 |
| Aishwariya S Vegunta | 267 Grant St, Bridgeport, CT 06610-2805 | Resident Physician | 2020-07-01 ~ 2024-06-30 |
| Rasha T Ismail | 267 Grant St, Bridgeport, CT 06610-2805 | Resident Physician | 2020-07-01 ~ 2024-06-30 |
| Mark Steven Mcfarland | 267 Grant St, Bridgeport, CT 06610-2805 | Resident Physician | 2018-07-01 ~ 2023-06-30 |
| Benjamin Hans Jeuk | 267 Grant St, Bridgeport, CT 06610 | Resident Physician | 2020-06-22 ~ 2023-06-30 |
| Lucia Plichtova | 267 Grant St, Bridgeport, CT 06610-2805 | Resident Physician | 2020-06-22 ~ 2023-06-30 |
| Kwabena Sefah Nketiah Sarpong | 267 Grant St, Bridgeport, CT 06610-2805 | Resident Physician | 2020-06-22 ~ 2023-06-30 |
| Prajna D'silva | 267 Grant St, Bridgeport, CT 06610-2805 | Resident Physician | 2020-06-22 ~ 2023-06-30 |
| Fabricio Malaguez Webber | 267 Grant St, Bridgeport, CT 06610-2805 | Resident Physician | 2020-06-22 ~ 2023-06-30 |
| Find all Licenses in the same address | |||
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Gilead I Lancaster Md | 267 Grant St Fl 10, Bridgeport, CT 06610-2805 | Physician/surgeon | 2020-06-01 ~ 2021-05-31 |
| Nabil A Atweh | 267 Grant St Fl 8, Bridgeport, CT 06610-2805 | Physician/surgeon | 2020-06-01 ~ 2021-05-31 |
| Edwin Jin Su Lee | 297 Grant St, Bridgeport, CT 06610-2805 | Controlled Substance Registration for Practitioner | 2017-08-11 ~ 2019-02-28 |
| Wilhelmina Jackson | 226 Mill Hill Ave., Bridgeport, CT 06610-2805 | Controlled Substance Registration for Practitioner | 2017-03-01 ~ 2019-02-28 |
| Joanna Zolkowski-wynne | 267 Grant St # 5000, Bridgeport, CT 06610-2805 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Mohammad A Younus | 287 Grant St, Bridgeport, CT 06610-2805 | Controlled Substance Registration for Practitioner | 2011-03-01 ~ 2013-02-28 |
| Maximilian Klein | Bridgeport Hospital, Bridgeport, CT 06610-2805 | Controlled Substance Registration for Practitioner | 2015-03-01 ~ 2017-02-28 |
| Edosa I Odaro | 267 Grant Street, Bridgeport, CT 06610-2805 | Controlled Substance Registration for Practitioner | 2013-03-01 ~ 2015-02-28 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Nilca Janice Cardenales | 66 Rose St, Bridgeport, CT 06610 | Combination Nail Technician, Esthetician Or Eyelash Technici | ~ |
| Kiara Lizbeth Corporan | 10 Sturtevant Pl, Bridgeport, CT 06610 | Eyelash Technician | ~ |
| Alisha Garcia | 65 Berkeley Place, Bridgeport, CT 06610 | Notary Public Appointment | 2020-06-26 ~ 2025-06-30 |
| Pauline Parkes | 96 Virginia Avenue, Bridgeport, CT 06610 | Licensed Clinical Social Worker | ~ |
| Denise Reyes | 1125 Huntington Turnpike, Bridgeport, CT 06610 | Registered Nurse | 2020-07-01 ~ 2021-06-30 |
| Avery M Rilley | 80 Granfield Avenue, Bridgeport, CT 06610 | Pharmacy Technician | 2020-06-25 ~ 2021-03-31 |
| Bozena K. Malyszko | Bridgeport Hospital, Bridgeport, CT 06610 | Physician/surgeon | 2020-07-01 ~ 2021-06-30 |
| Amy Espinosa | 146 Court D, Bridgeport, CT 06610 | Notary Public Appointment | 2020-07-01 ~ 2025-06-30 |
| Wilhelmina Jackson · Thomas | 172 Court D, Bridgeport, CT 06610 | Registered Nurse | 2020-08-01 ~ 2021-07-31 |
| Emma Agyeiwaa Vaczek | P.o Box 5223, Bridgeport, CT 06610 | Licensed Practical Nurse | 2020-08-01 ~ 2021-07-31 |
| Find all Licenses in zip 06610 | |||
| City | BRIDGEPORT |
| Zip Code | 06610 |
| License Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| License Type + County | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER + BRIDGEPORT |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| W Bradley Davis Dvm | Davis Companion Animal Hospital, Woodbury, CT 06798 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Ben Shneider Md | 64 Davis Dr, Guilford, CT 06437 | Controlled Substance Registration for Practitioner | 1997-03-04 ~ 1998-02-28 |
| Kelly M Deforest | 267 Rte 87, Columbia, CT 06237 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Kelly M. Doran Md | New Haven, CT 06511 | Controlled Substance Registration for Practitioner | 2013-03-01 ~ 2015-02-28 |
| Kelly M Ferjentsik | 34 Little Fox Ln, Monroe, CT 06468-1607 | 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 J Way | 34 B Springbrook Rd, Westerly, RI 02891 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Lynn K Davis Md | 273 Founders Rd, Glastonbury, CT 06033-3213 | Controlled Substance Registration for Practitioner | 2015-03-01 ~ 2017-02-28 |
| Ashley Davis | 123 York St Apt 6d, New Haven, CT 06511-5621 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Daniel G Davis Do | 166 W Broad St, Stamford, CT 06902 | Controlled Substance Registration for Practitioner | 2013-03-01 ~ 2015-02-28 |
Please comment or provide details below to improve the information on KELLY DAVIS.
| 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).