SUSANNA K JACOB (Credential# 1308110) 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.
SUSANNA K JACOB is licensed with the Department of Consumer Protection of Connecticut. The credential number is #CSP.0061402. 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 23018 88th Ave, Queens Village, NY 11427-2623. The current status is active.
| Licensee Name | SUSANNA K JACOB |
| Credential ID | 1308110 |
| Credential Number | CSP.0061402 |
| Credential Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| Business Address |
23018 88th Ave Queens Village NY 11427-2623 |
| Business Type | INDIVIDUAL |
| Status | ACTIVE - CURRENT |
| Active | 1 |
| Issue Date | 2015-09-01 |
| Effective Date | 2019-03-01 |
| Expiration Date | 2021-02-28 |
| Refresh Date | 2019-03-04 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 1298746 | 2.011453 | Dentist | 2015-07-22 | 2020-01-01 - 2020-12-31 | ACTIVE |
| Street Address | 23018 88TH AVE |
| City | QUEENS VILLAGE |
| State | NY |
| Zip Code | 11427-2623 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Mengjie Yu | 219-50 Hartland Ave, Queens Village, NY 11427 | Combination Nail Technician, Esthetician Or Eyelash Technici | ~ |
| Kyungsun Kang | 80-47 234th St, Queens Village, NY 11427 | Combination Nail Technician, Esthetician Or Eyelash Technici | ~ |
| Emily Chan | 80-12 223rd St, Queens Village, NY 11427 | Emergency Medical Technician | ~ |
| Md Sharif Al Kamal | 8963 219th St, Queens Village, NY 11427 | Professional Engineer | 2014-02-01 ~ 2015-01-31 |
| Saleh A Bhuiyan | 88-21 218th Pl, Queens Village, NY 11427 | Professional Engineer | 2020-02-01 ~ 2021-01-31 |
| Piyal Alam | 80-59 222nd St, Hollis Hills, NY 11427 | Physician/surgeon | 2020-03-01 ~ 2021-02-28 |
| Md M Bhuiyan | 212 03 89th Ave, Queens Village, NY 11427 | Pharmacist | 2020-02-01 ~ 2022-01-31 |
| Nanik P Massand | 85-18 212th St, Queens Village, NY 11427 | Professional Engineer | 2020-02-01 ~ 2021-01-31 |
| Fahad H Chaudhury | 89-77 210th Steet, Queens Village, NY 11427 | Professional Engineer | 2020-02-01 ~ 2021-01-31 |
| Rsg Construction Corp | 89-03 Pontiac St, Queens Village, NY 11427 | Home Improvement Contractor | 2014-10-21 ~ 2015-11-30 |
| Find all Licenses in zip 11427 | |||
| City | QUEENS VILLAGE |
| Zip Code | 11427 |
| License Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| License Type + County | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER + QUEENS VILLAGE |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Susanna A Curtis | 4 S Main St Apt 205, Norwalk, CT 06854-2954 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Susanna Dahl Cronmiller | 537 Cascade Dr, Fairfield, CT 06825-2300 | Controlled Substance Registration for Practitioner | 2019-05-06 ~ 2021-02-28 |
| Susanna Vaystub Od | 4701 Fieldston Rd, Riverdale, NY 10471 | Controlled Substance Registration for Practitioner | 2013-03-01 ~ 2015-02-28 |
| Jacob D Siegel | 20 York St Rm 226, New Haven, CT 06510-3220 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Jacob C Wood | 10 Farmhill Dr, Plainville, CT 06062 | Controlled Substance Registration for Practitioner | 2017-03-01 ~ 2019-02-28 |
| Samuel Jacob | 574 Central Ave Apt 3a, New Haven, CT 06515-2154 | Controlled Substance Registration for Practitioner | 2011-08-29 ~ 2013-02-28 |
| Jacob J Rauchwerger Md | 334 Marlborough Rd, Cedarhurst, NY 11516-1113 | Controlled Substance Registration for Practitioner | 2009-03-02 ~ 2011-02-28 |
| Dexter D Jacob | 129 York St Apt 5a, New Haven, CT 06511-5605 | Controlled Substance Registration for Practitioner | 2015-03-01 ~ 2017-02-28 |
| Jacob C Nafziger | 49 Lake Dr S, New Fairfield, CT 06812-3510 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Jacob I Hentel Md | 122 Ridgeview Rd, Poughkeepsie, NY 12603-4264 | Controlled Substance Registration for Practitioner | 2013-03-01 ~ 2015-02-28 |
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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).