DORRANCE T KELLY (Credential# 144932) 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 ACTIVE.
DORRANCE T KELLY is licensed with the Department of Consumer Protection of Connecticut. The credential number is #CSP.0007744. 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 4154 Madison Ave, Trumbull, CT 06611-3563. The current status is active.
| Licensee Name | DORRANCE T KELLY |
| Credential ID | 144932 |
| Credential Number | CSP.0007744 |
| Credential Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| Business Address |
4154 Madison Ave Trumbull CT 06611-3563 |
| Business Type | INDIVIDUAL |
| Status | ACTIVE - CURRENT |
| Active | 1 |
| Issue Date | 1999-03-01 |
| Effective Date | 2019-03-01 |
| Expiration Date | 2021-02-28 |
| Refresh Date | 2019-01-28 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 700387 | 2.004346 | Dentist | 1971-04-17 | 2020-02-01 - 2021-01-31 | ACTIVE |
| 741605 | 22.004346 | Dental Anesthesia/Conscious Sedation Permit | 1989-09-25 | 2019-10-01 - 2020-09-30 | ACTIVE |
| Street Address | 4154 MADISON AVE |
| City | TRUMBULL |
| State | CT |
| Zip Code | 06611-3563 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| John J Bogannam | 4154 Madison Ave, Trumbull, CT 06611 | Chiropractor | 2020-06-01 ~ 2021-05-31 |
| Shafiulla Khan Dds | 4154 Madison Ave, Trumbull, CT 06611 | Controlled Substance Registration for Practitioner | 2009-03-01 ~ 2011-02-28 |
| Mohammed M Imam Dds | 4154 Madison Ave, Trumbull, CT 06611 | Controlled Substance Registration for Practitioner | 2009-03-20 ~ 2011-02-28 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Ashley S Balestriere | 7 Sutton Place, Trumbull, CT 06611 | Registered Nurse | 2020-08-01 ~ 2021-07-31 |
| Filomena L Ferraro · Nicolia | 35 Skating Pond Rd, Trumbull, CT 06611 | Registered Nurse | 2020-09-01 ~ 2021-08-31 |
| Alexis Grace Shaub | 58 Chestnut Hill Road, Trumbull, CT 06611 | Physician Assistant | 2020-08-01 ~ 2021-07-31 |
| Maria Bivona | 5302 Main Street, Trumbull, CT 06611 | Notary Public Appointment | 2020-10-01 ~ 2025-09-30 |
| Gina M Gallo · Liquigli | 20 Red Maple Lane, Trumbull, CT 06611 | Hairdresser/cosmetician | 2020-09-01 ~ 2022-08-31 |
| Xuehuan Zhang | 31 Asbury Rd, Trumbull, CT 06611 | Combination Nail Technician, Esthetician Or Eyelash Technici | ~ |
| Antoinette D Senior | 38 Tanager Lane, Trumbull, CT 06611 | Registered Nurse | 2020-07-01 ~ 2021-06-30 |
| Solution Construction LLC | 3 Stonewall Lane, Trumbull, CT 06611 | New Home Construction Contractor | 2020-06-18 ~ 2021-09-30 |
| Gary T Sorge | 63 Limerick Road, Trumbull, CT 06611 | Landscape Architect | 2020-08-01 ~ 2021-07-31 |
| Melodie T Noga | 55 Moose Hill Road, Trumbull, CT 06611 | Real Estate Salesperson | 2020-06-19 ~ 2021-05-31 |
| Find all Licenses in zip 06611 | |||
| City | TRUMBULL |
| Zip Code | 06611 |
| License Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| License Type + County | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER + TRUMBULL |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Christian A. Wysocki | 81 Dorrance St, Hamden, CT 06518-3343 | Controlled Substance Registration for Practitioner | 2013-03-01 ~ 2015-02-28 |
| Akira Kugaya | 128 Dorrance St, Hamden, CT 06518 | Controlled Substance Registration for Practitioner | 2006-03-01 ~ 2007-02-28 |
| Tanya D Murtha | 5 Dorrance Pl, Hamden, CT 06518-3309 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Edward G Duval | 26 Dorrance St, Danielson, CT 06239 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Nicolaj Andersen Md | 21 Dorrance Place, Hamden, CT 06518 | Controlled Substance Registration for Practitioner | 2005-03-01 ~ 2006-02-28 |
| Timothy D Murtha | 5 Dorrance Place, Hamden, CT 06518 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Roxanne S Orlando | 73 W Dorrance Street, Kingston, PA 18704 | Controlled Substance Registration for Practitioner | 2009-03-01 ~ 2011-02-28 |
| Kelly J Way | 34 B Springbrook Rd, Westerly, RI 02891 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Kelly M Deforest | 267 Rte 87, Columbia, CT 06237 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Kelly M. Doran Md | New Haven, CT 06511 | Controlled Substance Registration for Practitioner | 2013-03-01 ~ 2015-02-28 |
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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).