ALPHONSO L MACK (Credential# 1246680) 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.
ALPHONSO L MACK is licensed with the Department of Consumer Protection of Connecticut. The credential number is #CSP.0058745. 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 30, Burlington, CT 06103. The current status is active.
| Licensee Name | ALPHONSO L MACK |
| Credential ID | 1246680 |
| Credential Number | CSP.0058745 |
| Credential Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| Business Address |
30 Burlington CT 06103 |
| Business Type | INDIVIDUAL |
| Status | ACTIVE - CURRENT |
| Active | 1 |
| Issue Date | 2014-09-24 |
| Effective Date | 2019-03-01 |
| Expiration Date | 2021-02-28 |
| Refresh Date | 2019-01-10 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 701206 | 2.005845 | Dentist | 1980-07-19 | 2019-10-01 - 2020-09-30 | ACTIVE |
| 148918 | CSP.0010013 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 2004-12-08 | 2015-03-01 - 2017-02-28 | INACTIVE |
| 741529 | 21.005845 | Dental Conscious Sedation Permit | 1995-02-24 | 2015-03-01 - 2016-02-29 | INACTIVE |
| 1263208 | CSP.0059261 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | - | INACTIVE |
| Street Address | 30 |
| City | Burlington |
| State | CT |
| Zip Code | 06103 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Sutherland Pinot Noir | Connecicut Brand Registration, Hartford, CT 06103 | Liquor Brand Label | 2020-09-01 ~ 2023-08-30 |
| Subway of Union Station Hartford | 1 Union Pl, Hartford, CT 06103 | Bakery | 2020-07-01 ~ 2021-06-30 |
| Subway of Main St | 493 Main St, Hartford, CT 06103 | Bakery | 2020-07-01 ~ 2021-06-30 |
| Subway of Downtown Hartford | 65 Asylum St, Hartford, CT 06103 | Bakery | 2020-07-01 ~ 2021-06-30 |
| Alba Lucia Correa Ortiz | 427 Church St, Hartford, CT 06103 | Registered Nurse | 2020-07-01 ~ 2021-06-30 |
| Jeffrey L Cohen | One State St., Hartford, CT 06103 | Physician/surgeon | 2020-07-01 ~ 2021-06-30 |
| Thomas Kim | 111 Pearl Street #515, Hartford, CT 06103 | Resident Physician | 2020-07-01 ~ 2023-06-30 |
| Christina Dorry | 915 Main St Apt 602, Hartford, CT 06103 | Barber | 2020-09-01 ~ 2022-08-31 |
| 360 Mango Flavored Vodka | Connecticut Brand Reigstration, Hartford, CT 06103 | Liquor Brand Label | 2020-08-02 ~ 2023-07-31 |
| Margarita Toro · Bashners Market | 1293 Main St, Hartford, CT 06103 | Package Store Liquor | 2020-07-26 ~ 2021-07-25 |
| Find all Licenses in zip 06103 | |||
| City | Burlington |
| Zip Code | 06103 |
| License Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| License Type + County | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER + Burlington |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| John E Kelleher Jr | 26 Mack Rd, Middlefield, CT 06455-1104 | Controlled Substance Registration for Practitioner | 2015-03-01 ~ 2017-02-28 |
| James G Pattillo IIi | 74 Mack St, Windsor, CT 06095 | Controlled Substance Registration for Practitioner | 1999-03-01 ~ 2000-02-28 |
| Steven C Fitch | 321 Mack Rd, Lebanon, CT 06249-1718 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Lisa Mack | 85 Seymour St, Hartford, CT 06106-5501 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Michael J Mack | 40 E Putnam Avenue, Cos Cob, CT 06807 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Sarah Daigle | 72 Mack St., Windsor, CT 06095 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Philip W Mack Md | 6 Ericka Cir, East Longmeadow, MA 01028-1658 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Jeremy Roger Mack | 19 E 88th St Apt 1d, New York, NY 10128-0558 | Controlled Substance Registration for Practitioner | 2019-07-16 ~ 2021-02-28 |
| Shahena Master Do | 74 Mack Street, Windsor, CT 06095 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Jane A Mack | 1918 Huntington Tpk, Trumbull, CT 06611 | Controlled Substance Registration for Practitioner | 2005-03-01 ~ 2006-02-28 |
Please comment or provide details below to improve the information on ALPHONSO L MACK.
| 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).