NICOLE B FERNANDEZ (Credential# 1517098) 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 INACTIVE.
NICOLE B FERNANDEZ is licensed with the Department of Consumer Protection of Connecticut. The credential number is #CSP.0068247. 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 25 Peterborough St Apt 14, Boston, MA 02215-4410. The current status is inactive.
| Licensee Name | NICOLE B FERNANDEZ |
| Credential ID | 1517098 |
| Credential Number | CSP.0068247 |
| Credential Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| Business Address |
25 Peterborough St Apt 14 Boston MA 02215-4410 |
| Business Type | INDIVIDUAL |
| Status | INACTIVE - LACK OF ACTIVE MEDICAL LICENSE |
| Issue Date | 2018-05-23 |
| Effective Date | 2019-03-01 |
| Expiration Date | 2021-02-28 |
| Refresh Date | 2020-04-21 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 1503224 | 12.007582 | Advanced Practice Registered Nurse | 2018-05-22 | 2018-05-22 - 2019-05-31 | INACTIVE |
| 1399850 | 10.141981 | Registered Nurse | 2017-05-01 | 2018-06-01 - 2019-05-31 | INACTIVE |
| Street Address | 25 PETERBOROUGH ST APT 14 |
| City | BOSTON |
| State | MA |
| Zip Code | 02215-4410 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Providence Strategic Growth Europe, Lp | Landmark Center, Boston, MA 02215 | Securities - Exemptions | ~ |
| Dana-farber Cancer Institute Inc | 450 Brookline Ave, Boston, MA 02215 | Nonresident Pharmacy | ~ |
| Kelly Zhang | 400 Brookline Ave, Boston, MA 02215 | Pharmacist | 2020-02-01 ~ 2022-01-31 |
| Red Sox Foundation | 4 Jersey Street, Boston, MA 02215 | Public Charity | 2019-12-01 ~ 2020-11-30 |
| James V Hennessey | Beth Israel Deaconness Mc, Boston, MA 02215 | Physician/surgeon | 2020-01-01 ~ 2020-12-31 |
| Marc-david Munk | 136 Brookline Ave, Boston, MA 02215 | Physician/surgeon | 2018-06-01 ~ 2019-05-31 |
| Walgreens #10996 | 429 Brookline Ave., Boston, MA 02215 | Nonresident Pharmacy | 2019-09-01 ~ 2020-08-31 |
| Inga-marie Schaefer | 19 Queensberry Street, Boston, MA 02215 | Physician/surgeon | 2018-02-01 ~ 2019-02-28 |
| Bhaskar Roy | 111 Park Drive, Boston, MA 02215 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| David E Denny | 51 Park Dr #2, Boston, MA 02215 | Professional Engineer | 2012-03-12 ~ 2013-01-31 |
| Find all Licenses in zip 02215 | |||
| City | BOSTON |
| Zip Code | 02215 |
| License Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| License Type + County | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER + BOSTON |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Thomas V Fernandez Md | 350 George St, New Haven, CT 06511 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Yvette M Fernandez | 836 N Salem Rd, Ridgefield, CT 06877-1723 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| David Fernandez Pa | 86 Florence Rd, Riverside, CT 06878 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| James Fernandez Dds | 7 West Elm #a4, Greenwich, CT 06830 | Controlled Substance Registration for Practitioner | 1998-03-30 ~ 1999-02-28 |
| Maximo J Fernandez | 24 Hospital Ave, Danbury, CT 06810-6099 | Controlled Substance Registration for Practitioner | 2011-03-18 ~ 2013-02-28 |
| Gil M Fernandez Md | 4355 S National Ave Apt 1510, Springfield, MO 65810-2666 | Controlled Substance Registration for Practitioner | 2011-03-01 ~ 2013-02-28 |
| Ana M Fernandez Dds | 85 Aspen Drive, South Glastonbury, CT 06073 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Janice L Fernandez | 3626 Ruffin Rd, San Diego, CA 92123-1810 | Controlled Substance Registration for Practitioner | 2015-03-01 ~ 2017-02-28 |
| Andres Fernandez | 360 State St Apt 2619, New Haven, CT 06510-3627 | Controlled Substance Registration for Practitioner | 2013-07-08 ~ 2015-02-28 |
| Ignacio F Fernandez-nievas | 900 Chapel St #238, New Haven, CT 06510 | Controlled Substance Registration for Practitioner | 2006-03-01 ~ 2007-02-28 |
Please comment or provide details below to improve the information on NICOLE B FERNANDEZ.
| 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).