KELLY M TYLER (Credential# 1469532) 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.
KELLY M TYLER is licensed with the Department of Consumer Protection of Connecticut. The credential number is #CSP.0067296. 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 Baystate Medical Center, Springfield, MA 01199. The current status is active.
| Licensee Name | KELLY M TYLER |
| Credential ID | 1469532 |
| Credential Number | CSP.0067296 |
| Credential Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| Business Address |
Baystate Medical Center Springfield MA 01199 |
| Business Type | INDIVIDUAL |
| Status | ACTIVE - CURRENT |
| Active | 1 |
| Issue Date | 2018-01-05 |
| Effective Date | 2019-03-01 |
| Expiration Date | 2021-02-28 |
| Refresh Date | 2019-01-02 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 1455631 | 1.057278 | Physician/Surgeon | 2018-01-02 | 2020-02-01 - 2021-01-31 | ACTIVE |
| Street Address | Baystate Medical Center |
| City | Springfield |
| State | MA |
| Zip Code | 01199 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Katya Ford · Ivanov | Baystate Medical Center, Springfield, MA 01199 | Physician/surgeon | 2020-06-01 ~ 2021-05-31 |
| Christopher N Otis | Baystate Medical Center, Springfield, MA 01199 | Physician/surgeon | 2020-05-01 ~ 2021-04-30 |
| Neal E Seymour | Baystate Medical Center, Springfield, MA 01199 | Physician/surgeon | 2019-08-01 ~ 2020-07-31 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Franklin Moore | Departmentt of Pathology, 759 Chestnut St, MA 01199 | Physician/surgeon | 2020-06-01 ~ 2021-05-31 |
| Oren W Johnson | 758 Chestnut Street, Springfield, MA 01199 | Physician/surgeon | 2020-05-01 ~ 2021-04-30 |
| Kimberly Ann Bucknor | 3400 B Main Street, Springfield, MA 01199 | Controlled Substance Registration for Practitioner | 2020-02-03 ~ 2021-02-28 |
| Kelly A Lynch | Baystate Medical Center, Dept. of Obgyn, Springfield, MA 01199 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Orlando L Torres | 140 High Street, Springfield, MA 01199 | Physician/surgeon | 2005-11-21 ~ 2006-07-31 |
| Richard M Engelman | 759 Chestnut St, Springfield, MA 01199 | Physician/surgeon | 2016-11-01 ~ 2017-10-31 |
| Lawrence C Peters | 759 Chestnut St, Springfield, MA 01199 | Physician/surgeon | 2016-08-01 ~ 2017-07-31 |
| Venkatrao Medarametla | C3350; Hospital Medidine, Springfield, MA 01199-0001 | Physician/surgeon | 2020-09-01 ~ 2021-08-31 |
| Jean M Hennebery | 759 Chestnut St, Springfield, MA 01199-1001 | Physician/surgeon | 2019-10-01 ~ 2020-09-30 |
| Alok Kumar | 759 Chestnut St, Springfield, MA 01199-1001 | Physician/surgeon | ~ |
| Find all Licenses in zip 01199 | |||
| City | Springfield |
| Zip Code | 01199 |
| License Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| License Type + County | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER + Springfield |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Maureen C Kelly | 69 Tyler St, West Haven, CT 06516-6824 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Timothy Tyler Md | Po Box 138, Stonington, CT 06378-0138 | Controlled Substance Registration for Practitioner | 2017-03-01 ~ 2019-02-28 |
| Arlene Tyler | 282 Washington St, Hartford, CT 06106-3322 | Controlled Substance Registration for Practitioner | 2013-05-03 ~ 2015-02-28 |
| Tyler A Mammone | 28 Overlook Dr, Milford, CT 06460-4330 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Tyler Maddox | 11 Allen St Apt 3, Mystic, CT 06355-2972 | Controlled Substance Registration for Practitioner | 2019-06-05 ~ 2021-02-28 |
| Marta Kokoszynska | 12 Tyler Dr, Stamford, CT 06903-2201 | Controlled Substance Registration for Practitioner | 2015-03-01 ~ 2017-02-28 |
| Tyler Durazzo | 108 Kathrine Dr, Hamden, CT 06514-2710 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Sarah Misraji | 327 Tyler St, Fredericksburg, VA 22401-7141 | Controlled Substance Registration for Practitioner | 2020-01-06 ~ 2021-02-28 |
| Tyler F Stewart | 40 Amos St, Hamden, CT 06518-1802 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Tyler Leigh | 5 Perryridge Rd, Greenwich, CT 06830 | Controlled Substance Registration for Practitioner | 2007-03-01 ~ 2008-02-29 |
Please comment or provide details below to improve the information on KELLY M TYLER.
| 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).