MARK R CULLEN MD (Credential# 148573) is licensed (Controlled Substance Registration for Practitioner) with Connecticut Department of Consumer Protection. The license effective date is March 1, 2009. The license expiration date date is February 28, 2011. The license status is INACTIVE.
MARK R CULLEN MD is licensed with the Department of Consumer Protection of Connecticut. The credential number is #CSP.0004377. The credential type is controlled substance registration for practitioner. The effective date is March 1, 2009. The expiration date is February 28, 2011. The business address is 22 Lee Way, Madison, CT 06443. The current status is inactive.
| Licensee Name | MARK R CULLEN MD |
| Credential ID | 148573 |
| Credential Number | CSP.0004377 |
| Credential Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| Business Address |
22 Lee Way Madison CT 06443 |
| Business Type | INDIVIDUAL |
| Status | INACTIVE |
| Effective Date | 2009-03-01 |
| Expiration Date | 2011-02-28 |
| Refresh Date | 2013-03-07 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 543235 | 1.020060 | Physician/Surgeon | 1978-03-28 | 2009-01-16 - 2010-02-28 | INACTIVE |
| Street Address | 22 LEE WAY |
| City | MADISON |
| State | CT |
| Zip Code | 06443 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Juliette Roggeman-fumex | 22 Lee Way, Madison, CT 06443 | Real Estate Salesperson | 2017-06-05 ~ 2018-05-31 |
| Michele Barry Md | 22 Lee Way, Madison, CT 06443 | Controlled Substance Registration for Practitioner | 2009-03-01 ~ 2011-02-28 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Caitlyn Beverly Darosa | Lyle Dr, Madison, CT 06443 | Registered Nurse | ~ |
| Roberts Food Center · Rjf Inc Dba | 514 Old Toll Rd, Madison, CT 06443 | Operator of Weighing & Measuring Devices | 2020-08-01 ~ 2021-07-31 |
| Karen D Leonetti · Rapuano | 553 Green Hill Rd, Madison, CT 06443 | Radiographer | 2020-09-01 ~ 2021-08-31 |
| Pasquale Sabatasso | 122 River Edge Farms Road, Madison, CT 06443 | Barber | 2020-07-01 ~ 2022-06-30 |
| Madision Health Foods · Jum Ok Coker | 59 Wall St, Madison, CT 06443 | Operator of Weighing & Measuring Devices | 2020-08-01 ~ 2021-07-31 |
| Madison Community Services Inc. | P.o. Box 148, Madison, CT 06443 | Public Charity | 2020-12-01 ~ 2021-11-30 |
| Shaina Michele Levinson | 52 East Wharf Rd, Madison, CT 06443 | Master's Level Social Worker | ~ |
| Stephen G Lynch · Lynch, Stephen Gerard | 12 Milestone Lane, Madison, CT 06443 | Real Estate Salesperson | 2020-06-01 ~ 2021-05-31 |
| David F Courtney Md | 38 Old Duck Hole Road, Madison, CT 06443 | Physician/surgeon | 2020-07-01 ~ 2021-06-30 |
| Sydni E Marmor | 560 Opening Hill Road, Madison, CT 06443 | Professional Counselor | 2020-07-01 ~ 2021-06-30 |
| Find all Licenses in zip 06443 | |||
| City | MADISON |
| Zip Code | 06443 |
| License Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| License Type + County | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER + MADISON |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Cullen Taplin | 30 Washington St, Mystic, CT 06355-2815 | Controlled Substance Registration for Practitioner | 2019-06-24 ~ 2021-02-28 |
| Mary T Cullen Md | 27 Fernwood Rd, West Hartford, CT 06119 | Controlled Substance Registration for Practitioner | 2013-03-01 ~ 2015-02-28 |
| Thomas M Cullen | 40 Prospect Ave Bldg 1, Norwalk, CT 06850-3737 | Controlled Substance Registration for Practitioner | 2015-03-01 ~ 2017-02-28 |
| Susan Jones Cullen | 20 Hopmeadow St Unit 529, Weatogue, CT 06089-7934 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Mark P Goldstein Md | 754 E 6th St #5d, New York, NY 10009 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Mark C Lee Md | 282 Washington St, Hartford, CT 06106-3322 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Mark W Mossey | 227 Church St Apt 10b, New Haven, CT 06510-1824 | Controlled Substance Registration for Practitioner | 2013-03-01 ~ 2015-02-28 |
| Mark D Lorenze Md | 12 Bokum Rd, Essex, CT 06426 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Mark W Greve | 61 Three Corners Rd, Guilford, CT 06437 | Controlled Substance Registration for Practitioner | 2005-04-18 ~ 2006-02-28 |
| Mark Kolligian Dds | 654 Savin Ave, W Haven, CT 06516 | Controlled Substance Registration for Practitioner | 1993-11-03 ~ 1995-12-01 |
Please comment or provide details below to improve the information on MARK R CULLEN 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).