MINA A BOULOS (Credential# 1439119) is licensed (Controlled Substance Registration for Practitioner) with Connecticut Department of Consumer Protection. The license effective date is July 31, 2017. The license expiration date date is February 28, 2019. The license status is LAPSED.
MINA A BOULOS is licensed with the Department of Consumer Protection of Connecticut. The credential number is #CSP.0066361. The credential type is controlled substance registration for practitioner. The effective date is July 31, 2017. The expiration date is February 28, 2019. The business address is 78 Cedar St, Newington, CT 06111-2613. The current status is lapsed.
| Licensee Name | MINA A BOULOS |
| Credential ID | 1439119 |
| Credential Number | CSP.0066361 |
| Credential Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| Business Address |
78 Cedar St Newington CT 06111-2613 |
| Business Type | INDIVIDUAL |
| Status | LAPSED |
| Active | 1 |
| Issue Date | 2017-07-31 |
| Effective Date | 2017-07-31 |
| Expiration Date | 2019-02-28 |
| Refresh Date | 2019-03-06 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 1488118 | 2.011995-RES | Resident Dentist | 2017-07-01 | 2017-07-01 - 2018-06-30 | INACTIVE |
| Street Address | 78 CEDAR ST |
| City | NEWINGTON |
| State | CT |
| Zip Code | 06111-2613 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Eugene S Pak | 78 Cedar St, Newington, CT 06111-2647 | Optometrist | 2016-07-22 ~ 2017-06-30 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Walgreens #19842 | 40 Cedar St, Newington, CT 06111-2613 | Retail Dairy Store | 2019-07-01 ~ 2021-06-30 |
| Rite Aid #10348 | 40 Cedar St, Newington, CT 06111-2613 | Retail Dairy Store | 2017-07-01 ~ 2019-06-30 |
| Patricia A Gilmour | 88 Cedar St, Newington, CT 06111-2613 | Bingo Operator | 2014-11-24 ~ |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Anastasya Anisimova | 114 Fox Run Court, Newington, CT 06111 | Registered Nurse | 2020-08-01 ~ 2021-07-31 |
| Karen S Cleaveland | 52 Amidon Ave, Newington, CT 06111 | Registered Nurse | 2020-07-01 ~ 2021-06-30 |
| Leeann R Johnson | 17 Cinnamon Rd, Newington, CT 06111 | Notary Public Appointment | 2020-09-01 ~ 2025-08-31 |
| Isma Mian | 65 Cortland Way, Newington, CT 06111 | Physician/surgeon | ~ |
| Danielle Rocha | 1582 Willard Ave, Newington, CT 06111 | Notary Public Appointment | 2020-06-26 ~ 2025-06-30 |
| Munson's Chocolates | 3157 Berlin Tpke, Newington, CT 06111 | Operator of Weighing & Measuring Devices | 2020-08-01 ~ 2021-07-31 |
| Shandea Edwards | 21 Hartford Ave #14, Newington, CT 06111 | Medication Administration Certification | ~ |
| Hengchao Xiong | 47 Adam Dr, Newington, CT 06111 | Nail Technician | ~ |
| Tuyen Le Phan | 71 Lantern Hill, Newington, CT 06111 | Nail Technician | ~ |
| Smita Parth Dave | 192 Brookside Rd, Newington, CT 06111 | Esthetician | ~ |
| Find all Licenses in zip 06111 | |||
| City | NEWINGTON |
| Zip Code | 06111 |
| License Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| License Type + County | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER + NEWINGTON |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Mina Chang | 64 Robbins St, Waterbury, CT 06708-2613 | Controlled Substance Registration for Practitioner | 2011-03-01 ~ 2013-02-28 |
| Mina Owlia | 112 Southfield Ave Apt 402, Stamford, CT 06902-7637 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Mina Se Hanna | Apartment 3-j, New Haven, CT 06511 | Controlled Substance Registration for Practitioner | 2011-03-01 ~ 2013-02-28 |
| Mina Masry | 365 Montauk Ave, New London, CT 06320-4700 | Controlled Substance Registration for Practitioner | 2020-02-25 ~ 2021-02-28 |
| 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 Mecheal Benjamin Mehanni | 2961 Index Rd Apt 115, Fitchburg, WI 53713-3217 | Controlled Substance Registration for Practitioner | 2017-02-03 ~ 2019-02-28 |
| 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 | ~ |
Please comment or provide details below to improve the information on MINA A BOULOS.
| 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).