ZACKERY J MUNDUS (Credential# 1237519) 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.
ZACKERY J MUNDUS is licensed with the Department of Consumer Protection of Connecticut. The credential number is #CSP.0058368. 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 48 Blue Ridge Dr, Somers, CT 06071-1027. The current status is lapsed.
| Licensee Name | ZACKERY J MUNDUS |
| Credential ID | 1237519 |
| Credential Number | CSP.0058368 |
| Credential Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| Business Address |
48 Blue Ridge Dr Somers CT 06071-1027 |
| Business Type | INDIVIDUAL |
| Status | LAPSED |
| Active | 1 |
| Issue Date | 2014-07-31 |
| Effective Date | 2017-03-01 |
| Expiration Date | 2019-02-28 |
| Refresh Date | 2019-03-06 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 1234036 | 23.003151 | Physician Assistant | 2014-07-17 | 2017-04-01 - 2018-03-31 | INACTIVE |
| Street Address | 48 BLUE RIDGE DR |
| City | SOMERS |
| State | CT |
| Zip Code | 06071-1027 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Vincent Alvaro Pa | 48 Blue Ridge Dr, Somers, CT 06071 | Physician Assistant | 2020-08-01 ~ 2021-07-31 |
| Sharon L Alvaro | 48 Blue Ridge Dr, Somers, CT 06071-1027 | Registered Nurse | 2020-03-01 ~ 2021-02-28 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Sara Nicole Szalkiewicz | 42 Blue Ridge Dr, Somers, CT 06071-1027 | Registered Nurse | 2019-09-01 ~ 2020-08-31 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Rebecca's Country Pie | 35 Pinedale Rd, Somers, CT 06071 | Bakery | 2020-07-01 ~ 2021-06-30 |
| Joseph P Grzelak | 36 Pond Circle, Somers, CT 06071 | Psychologist | 2020-06-01 ~ 2021-05-31 |
| Susan P Haight | 51 Whisper Woods Drive, Somers, CT 06071 | Dental Hygienist | 2020-08-01 ~ 2021-07-31 |
| Alison Poppe | 121 Florida Rd, Somers, CT 06071 | Physician Assistant | 2020-07-01 ~ 2021-06-30 |
| Emily Pruden | 100 Bobolink Ln, Somers, CT 06071 | Registered Nurse | 2020-06-17 ~ 2020-11-30 |
| Matthew D Higgins | 10 Whisper Woods Drive, Somers, CT 06071 | Registered Nurse | 2020-08-01 ~ 2021-07-31 |
| Judith C Napolitano | 55 White Birch Circle, Somers, CT 06071 | Real Estate Salesperson | ~ |
| Mary Ellen Bickley | 552 Springfield Rd, Somers, CT 06071 | Registered Nurse | 2020-07-01 ~ 2021-06-30 |
| J C Real Estate Group LLC | 3 School St, Somers, CT 06071 | Real Estate Broker | 2020-04-01 ~ 2021-03-31 |
| Laurie A Mahon · Wirtalla | 531 Hallhill Rd, Somers, CT 06071 | Hairdresser/cosmetician | 2020-06-01 ~ 2022-05-31 |
| Find all Licenses in zip 06071 | |||
| City | SOMERS |
| Zip Code | 06071 |
| License Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| License Type + County | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER + SOMERS |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Catena Malbec Adrianna Mundus Bacillus | Connecticut Brand Registration, Hartford, CT 06106 | Liquor Brand Label | 2016-11-21 ~ 2019-11-20 |
| Catena-zapata Malbec Adrianna Mundus Bacillus Terrae | Connecticut Brand Registration, Hartford, CT 06106 | Liquor Brand Label | 2018-11-16 ~ 2021-11-15 |
| 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 |
| Min Jin Kim | 639 4th Ave Apt 5c, Brooklyn, NY 11232-1048 | Controlled Substance Registration for Practitioner | 2012-05-10 ~ 2013-02-28 |
| Erin K Fee | 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 |
| Arundati Rao | CT | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Huu Duc D Luu | 630 Mix Ave Apt 6p, Hamden, CT 06514-2320 | Controlled Substance Registration for Practitioner | 2011-03-01 ~ 2013-02-28 |
Please comment or provide details below to improve the information on ZACKERY J MUNDUS.
| 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).