JENINE E BOILEAU
Controlled Substance Registration for Practitioner


Address: 36 Eventide Ln, Levittown, PA 19054-2720

JENINE E BOILEAU (Credential# 1281625) 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 INACTIVE.

Business Overview

JENINE E BOILEAU is licensed with the Department of Consumer Protection of Connecticut. The credential number is #CSP.0059962. 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 36 Eventide Ln, Levittown, PA 19054-2720. The current status is inactive.

Basic Information

Licensee Name JENINE E BOILEAU
Credential ID 1281625
Credential Number CSP.0059962
Credential Type CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER
Business Address 36 Eventide Ln
Levittown
PA 19054-2720
Business Type INDIVIDUAL
Status INACTIVE - LACK OF ACTIVE MEDICAL LICENSE
Issue Date 2015-05-27
Effective Date 2019-03-01
Expiration Date 2021-02-28
Refresh Date 2020-04-23

Other licenses

ID Credential Code Credential Type Issue Term Status
1488360 1.057755-RES Resident Physician 2015-07-01 2015-07-01 - 2019-06-30 INACTIVE

Office Location

Street Address 36 EVENTIDE LN
City LEVITTOWN
State PA
Zip Code 19054-2720

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Joan M Reed 18 Morning Glory La, Levittown, PA 19054 Registered Nurse 1992-01-23 ~ 1993-01-31
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Stephen G Chatto Jr. 176 Northturn Lane, Levittown, PA 19054 Pharmacist 2006-02-01 ~ 2007-01-31
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Competitor

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City LEVITTOWN
Zip Code 19054
License Type CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER
License Type + County CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER + LEVITTOWN

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Dataset Information

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).

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