MARY T CULLEN MD (Credential# 148575) is licensed (Controlled Substance Registration for Practitioner) with Connecticut Department of Consumer Protection. The license effective date is March 1, 2013. The license expiration date date is February 28, 2015. The license status is INACTIVE.
MARY T CULLEN MD is licensed with the Department of Consumer Protection of Connecticut. The credential number is #CSP.0004076. The credential type is controlled substance registration for practitioner. The effective date is March 1, 2013. The expiration date is February 28, 2015. The business address is 27 Fernwood Rd, West Hartford, CT 06119. The current status is inactive.
| Licensee Name | MARY T CULLEN MD |
| Credential ID | 148575 |
| Credential Number | CSP.0004076 |
| Credential Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| Business Address |
27 Fernwood Rd West Hartford CT 06119 |
| Business Type | INDIVIDUAL |
| Status | INACTIVE |
| Effective Date | 2013-03-01 |
| Expiration Date | 2015-02-28 |
| Refresh Date | 2016-01-29 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 539639 | 1.010210 | Physician/Surgeon | 1960-11-02 | 2013-10-01 - 2014-09-30 | INACTIVE |
| Street Address | 27 FERNWOOD RD |
| City | WEST HARTFORD |
| State | CT |
| Zip Code | 06119 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Chester F Cullen Md | 27 Fernwood Rd, West Hartford, CT 06119 | Physician/surgeon | 2005-11-22 ~ 2006-12-31 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Danna Rae France | 1148 Boulevard, West Hartford, CT 06119 | Combination Nail Technician, Esthetician Or Eyelash Technici | 2020-06-27 ~ 2021-10-31 |
| Rayda R Bouma | 122 Richard St, West Hartford, CT 06119 | Registered Nurse | 2020-07-01 ~ 2021-06-30 |
| Norbert M Spencer | 17 Oakwood Ave., West Hartford, CT 06119 | Professional Counselor | 2020-07-01 ~ 2021-06-30 |
| Diedra A Dietter | 9 Birch Road, West Hartford, CT 06119 | Licensed Clinical Social Worker | 2020-07-01 ~ 2021-06-30 |
| Dahlia I Belnavis-bigenho · Belnavis | 186 Whiting Lane, West Hartford, CT 06119 | Respiratory Care Practitioner | 2020-08-01 ~ 2021-07-31 |
| Stephen R Dewey | 68 Richard St, W Hartford, CT 06119 | Architect | 2020-08-01 ~ 2021-07-31 |
| James E Vance Jr | 9 Plymouth Rd, W Hartford, CT 06119 | Architect | 2020-08-01 ~ 2021-07-31 |
| Mark D Hirsch | 105 Griswold Dr, W Hartford, CT 06119 | Architect | 2020-08-01 ~ 2021-07-31 |
| Judith Briggs | 29 Troy St, West Hartford, CT 06119 | Registered Nurse | 2020-07-01 ~ 2021-06-30 |
| Thulan P Vu | 74 Park Road, West Hartford, CT 06119 | Nail Technician | 2020-06-24 ~ 2022-06-30 |
| Find all Licenses in zip 06119 | |||
| City | WEST HARTFORD |
| Zip Code | 06119 |
| License Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| License Type + County | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER + WEST HARTFORD |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Mark R Cullen Md | 22 Lee Way, Madison, CT 06443 | Controlled Substance Registration for Practitioner | 2009-03-01 ~ 2011-02-28 |
| Cullen Taplin | 30 Washington St, Mystic, CT 06355-2815 | Controlled Substance Registration for Practitioner | 2019-06-24 ~ 2021-02-28 |
| 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 |
| Mary G Boy | 237 Clift St, Mystic, CT 06355-1726 | Controlled Substance Registration for Practitioner | 2018-12-20 ~ 2021-02-28 |
| Mary J O | 109 E Gate Ln, Hamden, CT 06514-2233 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Mary B O'malley | Po Box 447, Housatonic, MA 01236-0447 | Controlled Substance Registration for Practitioner | 2020-02-28 ~ 2021-02-28 |
| Mary T Pronovost Md | 111 Beach Rd, Fairfield, CT 06824 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Mary E Nichols | 704 Ridge Rd, Wethersfield, CT 06109 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Caroline Mary Ort | 389 Parker Ave S, Meriden, CT 06450-5954 | Controlled Substance Registration for Practitioner | 2020-01-07 ~ 2021-02-28 |
Please comment or provide details below to improve the information on MARY T 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).