MARK D STEVENS PA (Credential# 1247624) 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.
MARK D STEVENS PA is licensed with the Department of Consumer Protection of Connecticut. The credential number is #CSP.0058770. 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 188 Empress Dr, Southington, CT 06489-5103. The current status is active.
| Licensee Name | MARK D STEVENS PA |
| Credential ID | 1247624 |
| Credential Number | CSP.0058770 |
| Credential Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| Business Address |
188 Empress Dr Southington CT 06489-5103 |
| Business Type | INDIVIDUAL |
| Status | ACTIVE - CURRENT |
| Active | 1 |
| Issue Date | 2014-09-27 |
| Effective Date | 2019-03-01 |
| Expiration Date | 2021-02-28 |
| Refresh Date | 2019-01-09 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 742094 | 23.000345 | Physician Assistant | 1993-11-05 | 2020-01-01 - 2020-12-31 | ACTIVE |
| 162170 | CSP.0021713 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 2013-03-01 - 2015-02-28 | INACTIVE |
| Street Address | 188 EMPRESS DR |
| City | SOUTHINGTON |
| State | CT |
| Zip Code | 06489-5103 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Melissa A Kane | 142 Empress Dr, Southington, CT 06489-5103 | Speech and Language Pathologist | 2020-07-01 ~ 2021-06-30 |
| Kelly V Pogemiller | 100 Empress Dr, Southington, CT 06489-5103 | Physical Therapist | 2020-04-01 ~ 2021-03-31 |
| Creedance C Mongillo | 128 Empress Cir, Southington, CT 06489-5103 | Registered Nurse | 2020-04-01 ~ 2021-03-31 |
| Jason Flint · Unique Living Spaces | 164 Empress Dr, Southington, CT 06489-5103 | New Home Construction Contractor | 2019-10-01 ~ 2021-09-30 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Sarah M Moon | 321 Pilgrim Lane, Southington, CT 06489 | Esthetician | ~ |
| Joanna Milewski | 23 Stacy Cate Drive, Southington, CT 06489 | Registered Nurse | 2020-07-01 ~ 2021-06-30 |
| Richard M Testa | 81 Winter Park Road, Southington, CT 06489 | Massage Therapist | 2020-08-01 ~ 2022-07-31 |
| Valley Roofing LLC | 88 Ladyslipper Lane, Southington, CT 06489 | Home Improvement Contractor | ~ |
| Dunkin Donuts · New England Donuts LLC | 856 Queen St, Southington, CT 06489 | Bakery | 2020-07-01 ~ 2021-06-30 |
| Elizabeth E Pizzuto | 45 Water Street, Southington, CT 06489 | Real Estate Salesperson | 2020-06-18 ~ 2021-05-31 |
| Nicholas C Ingel | 515 West Street, Southington, CT 06489 | Heating, Piping & Cooling Limited Journeyperson | 2020-06-23 ~ 2021-08-31 |
| Tyrone J Correa | 84 Minthal Drive, Southington, CT 06489 | Real Estate Salesperson | 2020-06-19 ~ 2021-05-31 |
| Marilyn F Coppola | 114 Spring Hill Rd, Southington, CT 06489 | Registered Nurse | 2020-08-01 ~ 2021-07-31 |
| Christine M Liebler | 30 Sultana Terrace, Southington, CT 06489 | Registered Nurse | 2020-07-01 ~ 2021-06-30 |
| Find all Licenses in zip 06489 | |||
| City | SOUTHINGTON |
| Zip Code | 06489 |
| License Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| License Type + County | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER + SOUTHINGTON |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Connie Y Yu | 24 Stevens St, Norwalk, CT 06856 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Caroline P Kurtz Md | 30 Stevens St, Norwalk, CT 06850 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Joongho Shin | 30 Stevens St Ste D, Norwalk, CT 06850-3859 | Controlled Substance Registration for Practitioner | 2015-03-01 ~ 2017-02-28 |
| John F Dupont Jr | 38 Stevens Ln, Glastonbury, CT 06033-2956 | Controlled Substance Registration for Practitioner | 2013-03-01 ~ 2015-02-28 |
| Brenda J Stevens | 53 Derbyshire, Derby, CT 06418 | Controlled Substance Registration for Practitioner | 2003-03-01 ~ 2004-02-28 |
| Adarsh A Jha Md | 40 Stevens Rd, South Windsor, CT 06074-2398 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Reid Hopkins | 30 Stevens St Ste B, Norwalk, CT 06850-3859 | Controlled Substance Registration for Practitioner | 2019-05-13 ~ 2021-02-28 |
| Simona Ioja | 34 Stevens St, Norwalk, CT 06850-3813 | Controlled Substance Registration for Practitioner | 2013-03-01 ~ 2015-02-28 |
| Anna L Stevens | 177 Seneca Dr, Groton, CT 06340-5644 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Cristiana Golu Md | 55 Stevens Lane, Middletown, CT 06457 | Controlled Substance Registration for Practitioner | 2000-02-29 ~ 2001-02-28 |
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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).