MAMADI P KEITA (Credential# 1431320) 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.
MAMADI P KEITA is licensed with the Department of Consumer Protection of Connecticut. The credential number is #CSP.0065894. 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 1903 W Evergreen Ave Unit 1f, Chicago, IL 60622-1933. The current status is inactive.
| Licensee Name | MAMADI P KEITA |
| Credential ID | 1431320 |
| Credential Number | CSP.0065894 |
| Credential Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| Business Address |
1903 W Evergreen Ave Unit 1f Chicago IL 60622-1933 |
| Business Type | INDIVIDUAL |
| Status | INACTIVE - LACK OF ACTIVE MEDICAL LICENSE |
| Issue Date | 2018-02-01 |
| Effective Date | 2019-03-01 |
| Expiration Date | 2021-02-28 |
| Refresh Date | 2020-04-23 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 1488582 | 1.057977-RES | Resident Physician | 2017-07-01 | 2017-07-01 - 2019-06-30 | INACTIVE |
| Street Address | 1903 W EVERGREEN AVE UNIT 1F |
| City | CHICAGO |
| State | IL |
| Zip Code | 60622-1933 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Baker W Tee | 942 North Winchester, Chicago, IL 60622 | Professional Engineer | 2020-02-01 ~ 2021-01-31 |
| Douglas R Smego Md | 1718 N Wood Street, Chicago, IL 60622 | Controlled Substance Registration for Practitioner | 2017-03-01 ~ 2019-02-28 |
| Evan Gladstone | 924 N Noble St, Chicago, IL 60622 | Real Estate Broker | 2004-01-20 ~ 2004-03-31 |
| Nancy A Garrity | 1037 N Winchester St, Chicago, IL 60622 | Pharmacist | 1800-12-27 ~ 1993-03-31 |
| Camden D Breeding | 1713 N Marshfield Ave Apt 1, Chicago, IL 60622-0910 | Professional Engineer | 2020-04-21 ~ 2021-01-31 |
| Meghan L Schoenemann | 1712 N Wood St Apt 2w, Chicago, IL 60622-1424 | Pharmacist | 2017-05-17 ~ 2018-01-31 |
| Jodie A Bradley | 1534 N Claremont Ave Apt 1, Chicago, IL 60622-1781 | Registered Nurse | 2019-07-01 ~ 2020-06-30 |
| Jordan Daniel William England | 1440 N Wood St Apt 1f, Chicago, IL 60622-2041 | Certified Public Accountant License | 2018-11-14 ~ 2019-12-31 |
| Joan S Franklin | 1715 W Beach Ave Unit 1, Chicago, IL 60622-2109 | Psychologist | 2020-06-01 ~ 2021-05-31 |
| John A Chipman | 1740 N Marshfield Ave Apt 18, Chicago, IL 60622-2490 | Architect | 2019-08-01 ~ 2020-07-31 |
| Find all Licenses in zip 60622 | |||
| City | CHICAGO |
| Zip Code | 60622 |
| License Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| License Type + County | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER + CHICAGO |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Steven Kassels Md · Community Substance Abuse Center | Comm. Physicians PC/125 North Elm Street, Westfield, MA 01085 | Controlled Substance Registration for Practitioner | 2018-06-15 ~ 2019-02-28 |
| Shu-i Lin | CT | Controlled Substance Registration for Practitioner | 2017-06-12 ~ 2019-02-28 |
| Erin K Fee | CT | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Hae J Kim Pa | New Haven, CT 06511 | Controlled Substance Registration for Practitioner | 2008-03-31 ~ 2009-02-28 |
| Huu Duc D Luu | 630 Mix Ave Apt 6p, Hamden, CT 06514-2320 | Controlled Substance Registration for Practitioner | 2011-03-01 ~ 2013-02-28 |
| Qi Che Md | Bridgeport, CT 06610 | Controlled Substance Registration for Practitioner | 2006-03-01 ~ 2007-02-28 |
| Arundati Rao | CT | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Min Jin Kim | 639 4th Ave Apt 5c, Brooklyn, NY 11232-1048 | Controlled Substance Registration for Practitioner | 2012-05-10 ~ 2013-02-28 |
| Mai T Pho | 88 Linden St #2, New Haven, CT 06511 | Controlled Substance Registration for Practitioner | 2007-03-01 ~ 2008-02-29 |
| Rhianna M Little | Psc 2 Box 6188, Apo, AE 09012-0062 | Controlled Substance Registration for Practitioner | 2015-05-20 ~ 2017-02-28 |
Please comment or provide details below to improve the information on MAMADI P KEITA.
| 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).