GEROLD JENSEN MD (Credential# 143552) is licensed (Controlled Substance Registration for Practitioner) with Connecticut Department of Consumer Protection. The license effective date is November 8, 1995. The license expiration date date is February 28, 1997. The license status is INACTIVE.
GEROLD JENSEN MD is licensed with the Department of Consumer Protection of Connecticut. The credential number is #CSP.0007076. The credential type is controlled substance registration for practitioner. The effective date is November 8, 1995. The expiration date is February 28, 1997. The business address is 780 Farmington Ave, Bristol, CT 06010. The current status is inactive.
| Licensee Name | GEROLD JENSEN MD |
| Credential ID | 143552 |
| Credential Number | CSP.0007076 |
| Credential Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| Business Address |
780 Farmington Ave Bristol CT 06010 |
| Business Type | INDIVIDUAL |
| Status | INACTIVE - DOES NOT WISH TO RENEW |
| Effective Date | 1995-11-08 |
| Expiration Date | 1997-02-28 |
| Refresh Date | 2004-04-23 |
| Street Address | 780 FARMINGTON AVE |
| City | BRISTOL |
| State | CT |
| Zip Code | 06010 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Douglas Perry Md | 780 Farmington Ave, Bristol, CT 06010-3920 | Controlled Substance Registration for Practitioner | 2001-03-01 ~ 2002-02-28 |
| Douglas D Perry | 780 Farmington Ave, Bristol, CT 06010-3920 | Physician/surgeon | 2000-03-24 ~ 2001-05-31 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Deborah M Dube · Adamaitis | 33 Peck Lane, Bristol, CT 06010 | Licensed Practical Nurse | 2020-07-01 ~ 2021-06-30 |
| Barbara M Williams | 45 Harrison Street, Bristol, CT 06010 | Notary Public Appointment | 2020-08-01 ~ 2025-07-31 |
| Le Bao Linh Nguyen | 229 Silo Rd, Bristol, CT 06010 | Nail Technician | ~ |
| Tara M Chipman | 38 Grove St, Bristol, CT 06010 | Licensed Practical Nurse | 2020-07-01 ~ 2021-06-30 |
| Jaclyn J Brandolini | 424 Emmett St, Bristol, CT 06010 | Registered Nurse | 2020-07-01 ~ 2021-06-30 |
| Hoa Le | 63 Seminary St, Bristol, CT 06010 | Nail Technician | ~ |
| Barbara E Trench | 25 Peacedale St, Bristol, CT 06010 | Hairdresser/cosmetician | 2020-07-01 ~ 2022-06-30 |
| Tisha A Balfour | 379 West Street, Bristol, CT 06010 | Licensed Practical Nurse | 2020-08-01 ~ 2021-07-31 |
| Meredith Rose Martineau | 15 Bishop Street, Bristol, CT 06010 | Master's Level Social Worker - Temporary Permit | 2020-06-26 ~ 2020-09-06 |
| Jaime L Krueger | 130 Garfield Road, Bristol, CT 06010 | Notary Public Appointment | 2020-06-26 ~ 2025-06-30 |
| Find all Licenses in zip 06010 | |||
| City | BRISTOL |
| Zip Code | 06010 |
| License Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| License Type + County | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER + BRISTOL |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Rachel A Jensen | 177 Glenwood Rd, Clinton, CT 06413-1424 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Peter R. Jensen Md | 184 Canoe Hill Rd, New Canaan, CT 06840-3706 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Charles W Jensen IIi | Dearfield Med Bldg, Greenwich, CT 06831 | Controlled Substance Registration for Practitioner | 1994-11-07 ~ 1996-12-01 |
| Tomonori Nakagama | 1138 Jensen Ave, Mamaroneck, NY 10543-3839 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Charles W Jensen Jr | Dearfield Med Bldg, Greenwich, CT 06831 | Controlled Substance Registration for Practitioner | 1993-11-03 ~ 1995-12-01 |
| Alison Jensen | 39 Alexander Rd Unit 6, Salem, CT 06420-3500 | Controlled Substance Registration for Practitioner | 2019-07-29 ~ 2021-02-28 |
| Abigail L Jensen | 9 Lexington Dr, East Granby, CT 06026-9548 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Kerri M Varney | 200 N El Mar Dr Unit 204a, Jensen Beach, FL 34957 | Controlled Substance Registration for Practitioner | 2017-03-01 ~ 2019-02-28 |
| Gary J. Curcio | 1098 Ne Post Oak Way, Jensen Beach, FL 34957 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Lori Jensen Cretella | 6 Divine Street, North Haven, CT 06473 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
Please comment or provide details below to improve the information on GEROLD JENSEN MD.
| 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).