MINA MECHEAL BENJAMIN MEHANNI (Credential# 1401280) is licensed (Controlled Substance Registration for Practitioner) with Connecticut Department of Consumer Protection. The license effective date is February 3, 2017. The license expiration date date is February 28, 2019. The license status is LAPSED.
MINA MECHEAL BENJAMIN MEHANNI is licensed with the Department of Consumer Protection of Connecticut. The credential number is #CSP.0064717. The credential type is controlled substance registration for practitioner. The effective date is February 3, 2017. The expiration date is February 28, 2019. The business address is 2961 Index Rd Apt 115, Fitchburg, WI 53713-3217. The current status is lapsed.
| Licensee Name | MINA MECHEAL BENJAMIN MEHANNI |
| Credential ID | 1401280 |
| Credential Number | CSP.0064717 |
| Credential Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| Business Address |
2961 Index Rd Apt 115 Fitchburg WI 53713-3217 |
| Business Type | INDIVIDUAL |
| Status | LAPSED |
| Active | 1 |
| Issue Date | 2017-02-03 |
| Effective Date | 2017-02-03 |
| Expiration Date | 2019-02-28 |
| Refresh Date | 2019-03-06 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 1388967 | 1.056126 | Physician/Surgeon | 2017-02-01 | 2017-02-01 - 2017-10-31 | INACTIVE |
| Street Address | 2961 INDEX RD APT 115 |
| City | FITCHBURG |
| State | WI |
| Zip Code | 53713-3217 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Yuki C Tse | 2928 Curry Parkway, Apt. 14, Madison, WI 53713 | Veterinarian | 2009-07-07 ~ 2009-12-31 |
| Kathleen A Strupp | 1501 Martin St #6, Madison, WI 53713 | Registered Nurse | 1981-01-01 ~ 1994-04-30 |
| Gail E Carr | 422 Lone Eagle Dr, Madison, WI 53713 | Registered Nurse | 1992-08-26 ~ 1993-08-31 |
| Leiner Health Products Inc · Daniel Knuteson | 2300 Badger Lane, Madison, WI 53713 | Wholesaler of Drugs, Cosmetics & Medical Devices | 1998-07-06 ~ 1999-06-30 |
| Pse Sc Inc | 1532 W Broadway Ste 103, Monona, WI 53713-1827 | Professional Engineering Corporation | 2019-12-05 ~ 2020-12-04 |
| Casey J Steuer | 5512 Ethelwyn Rd, Madison, WI 53713-2230 | Engineer-in-training | 2008-06-10 ~ 2018-06-10 |
| Robert T Peyton | 3006 Irvington Way, Madison, WI 53713-3414 | Psychologist | 2015-09-01 ~ 2016-08-31 |
| Lynn M Peyton · Moorhouse | 3006 Irvington Way, Madison, WI 53713-3414 | Licensed Clinical Social Worker | 2011-05-01 ~ 2012-04-30 |
| Dana Schippman | 1400 Post Rd Apt 208, Fitchburg, WI 53713-4244 | Genetic Counselor | 2020-04-01 ~ 2021-03-31 |
| Grand Leisure Usa Corp | 709 Post Rd, Madison, WI 53713-4621 | Importer of Bedding & Upholstered Furniture | 2020-05-01 ~ 2021-04-30 |
| Find all Licenses in zip 53713 | |||
| City | FITCHBURG |
| Zip Code | 53713 |
| License Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| License Type + County | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER + FITCHBURG |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Mina A Boulos | 78 Cedar St, Newington, CT 06111-2613 | Controlled Substance Registration for Practitioner | 2017-07-31 ~ 2019-02-28 |
| Mina Owlia | 112 Southfield Ave Apt 402, Stamford, CT 06902-7637 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Mina Masry | 365 Montauk Ave, New London, CT 06320-4700 | Controlled Substance Registration for Practitioner | 2020-02-25 ~ 2021-02-28 |
| Mina Se Hanna | Apartment 3-j, New Haven, CT 06511 | Controlled Substance Registration for Practitioner | 2011-03-01 ~ 2013-02-28 |
| Mina Chang | 64 Robbins St, Waterbury, CT 06708-2613 | Controlled Substance Registration for Practitioner | 2011-03-01 ~ 2013-02-28 |
| Mina R Rasoulpour Md | 8 Ellsworth Rd, West Hartford, CT 06107 | Controlled Substance Registration for Practitioner | 2011-03-01 ~ 2013-02-28 |
| Mina Ranzurmal Dds | 5726 Main Street, Trumbull, CT 06611 | Controlled Substance Registration for Practitioner | 2011-03-01 ~ 2013-02-28 |
| Mina Raju Do | 1164 Farmington Avenue, West Hartford, CT 06107 | Controlled Substance Registration for Practitioner | 2007-03-01 ~ 2008-02-29 |
| Mina Louis Habib Boutrous | 8814 Oak Creek Dr, Saint Louis, MO 63126-2130 | Controlled Substance Registration for Practitioner | 2019-11-19 ~ 2021-02-28 |
| Mina Mina | 263 Farmington Ave, Farmington, CT 06030-0001 | Controlled Substance Laboratory | ~ |
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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).