MATTHEW R BRACKMAN (Credential# 1322393) 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.
MATTHEW R BRACKMAN is licensed with the Department of Consumer Protection of Connecticut. The credential number is #CSP.0061794. 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 646 Converse St, Longmeadow, MA 01106-1715. The current status is lapsed.
| Licensee Name | MATTHEW R BRACKMAN |
| Credential ID | 1322393 |
| Credential Number | CSP.0061794 |
| Credential Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| Business Address |
646 Converse St Longmeadow MA 01106-1715 |
| Business Type | INDIVIDUAL |
| Status | LAPSED |
| Active | 1 |
| Issue Date | 2015-11-25 |
| Effective Date | 2017-03-01 |
| Expiration Date | 2019-02-28 |
| Refresh Date | 2019-03-06 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 1192005 | 1.052834 | Physician/Surgeon | 2014-03-13 | 2016-11-01 - 2017-10-31 | INACTIVE |
| Street Address | 646 CONVERSE ST |
| City | LONGMEADOW |
| State | MA |
| Zip Code | 01106-1715 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Michael S Caronna | 24 Chandler Ave, Longmeadow, MA 01106 | Registered Sanitarian | 2020-09-01 ~ 2021-08-31 |
| Susan Helen Templeton | 146 Pleasantview Avenue, Longmeadow, MA 01106 | Registered Nurse | ~ |
| Brittany Moreland | 103 Birchwood Ave, Longmeadow, MA 01106 | Real Estate Salesperson | 2020-06-22 ~ 2021-05-31 |
| Krystyna Olczuk | 158 Tanglewood Dr, Longmeadow, MA 01106 | Registered Nurse | 2020-08-01 ~ 2021-07-31 |
| Susan M Neville | 43 Lincoln Road, Longmeadow, MA 01106 | Registered Nurse | 2020-07-01 ~ 2021-06-30 |
| Kate E Schoenberger | 91 Williston Dr, Longmeadow, MA 01106 | Paramedic | 2020-09-01 ~ 2021-08-31 |
| Bryant E Ostrander | 52 Whitmun Road, Longmeadow, MA 01106 | Notary Public Appointment | 2020-10-01 ~ 2025-09-30 |
| Minsook Ku | 23 Herbert Street, Longmeadow, MA 01106 | Combination Nail Technician, Esthetician Or Eyelash Technici | 2020-06-12 ~ 2022-01-31 |
| Lily Schneider | 160 Captain Rd, Longmeadow, MA 01106 | Emergency Medical Technician | ~ |
| Kimberly Marie Maynard | 175 Franklin Road, Longmeadow, MA 01106 | Psychologist | 2020-07-01 ~ 2021-06-30 |
| Find all Licenses in zip 01106 | |||
| City | LONGMEADOW |
| Zip Code | 01106 |
| License Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| License Type + County | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER + LONGMEADOW |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Matthew B Palmer | CT | Controlled Substance Registration for Practitioner | ~ |
| Matthew Lin | 5 Van Winkle St, Bloomfield, NJ 07003 | Controlled Substance Registration for Practitioner | 2015-06-29 ~ 2017-02-28 |
| Matthew J Finn | 18 W Elm St, New Haven, CT 06515-2129 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Matthew D Cole | 123 York St Apt 9c, New Haven, CT 06511 | Controlled Substance Registration for Practitioner | 2006-03-01 ~ 2007-02-28 |
| Matthew J Dacosta | 933 Maplewood St, New Bedford, MA 02745-3308 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Matthew H Andersen | 88 Obtuse Rd S, Brookfield, CT 06804-3131 | Controlled Substance Registration for Practitioner | 2009-09-10 ~ 2011-02-28 |
| Matthew H Dodd | 15 York St, New Haven, CT 06520 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Matthew S Cook Pa-c | 21 Avon St # 3, New Haven, CT 06511-2522 | Controlled Substance Registration for Practitioner | 2009-03-01 ~ 2011-02-28 |
| Matthew D Paul | 69 Sand Pit Rd, Danbury, CT 06810 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Matthew D Howell Md | 208 Dogwood Ct, Yorktown, VA 23692 | Controlled Substance Registration for Practitioner | 2009-03-20 ~ 2011-02-28 |
Please comment or provide details below to improve the information on MATTHEW R BRACKMAN.
| 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).