SHAWNA MARIE KETTYLE (Credential# 1522990) 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.
SHAWNA MARIE KETTYLE is licensed with the Department of Consumer Protection of Connecticut. The credential number is #CSP.0068644. 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 201 Captains Walk, Stratford, CT 06614-4470. The current status is active.
| Licensee Name | SHAWNA MARIE KETTYLE |
| Credential ID | 1522990 |
| Credential Number | CSP.0068644 |
| Credential Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| Business Address |
201 Captains Walk Stratford CT 06614-4470 |
| Business Type | INDIVIDUAL |
| Status | ACTIVE - CURRENT |
| Active | 1 |
| Issue Date | 2018-07-25 |
| Effective Date | 2019-03-01 |
| Expiration Date | 2021-02-28 |
| Refresh Date | 2019-02-08 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 1511403 | 1.061673 | Physician/Surgeon | 2018-07-25 | 2019-10-01 - 2020-09-30 | ACTIVE |
| Street Address | 201 CAPTAINS WALK |
| City | STRATFORD |
| State | CT |
| Zip Code | 06614-4470 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Nicole Marie Minaudo | 80 Barrows Ter, Stratford, CT 06614 | Registered Nurse | 2020-09-01 ~ 2021-08-31 |
| Constance Greene | 65 Pamela Drive, Stratford, CT 06614 | Registered Nurse | 2020-08-01 ~ 2021-07-31 |
| Courtney M Blaze | 90 Mercer Street, Stratford, CT 06614 | Massage Therapist | 2020-07-01 ~ 2022-06-30 |
| William E Rosner Md | 81 B Seminole Lane, Stratford, CT 06614 | Physician/surgeon | 2020-07-01 ~ 2021-06-30 |
| Demetrius I Mcqueen | 60 Emerald Pl, Stratford, CT 06614 | Real Estate Salesperson | 2020-06-26 ~ 2021-05-31 |
| Alan Goldberg | 1825 Barnum Ave, Stratford, CT 06614 | Dentist | 2020-09-01 ~ 2021-08-31 |
| Kimberly L Matakevich | 1367 Nichols Avenue, Stratford, CT 06614 | Licensed Practical Nurse | 2020-09-01 ~ 2021-08-31 |
| Marybeth Nemergut | 990 Chapel St, Stratford, CT 06614 | Registered Nurse | 2020-08-01 ~ 2021-07-31 |
| Geraldine C Corry | 135 Wigwam Lane, Stratford, CT 06614 | Real Estate Salesperson | 2020-06-01 ~ 2021-05-31 |
| Kathleen Sajgovic | 300 Post Oak Rd, Stratford, CT 06614 | Registered Nurse | 2020-08-01 ~ 2021-07-31 |
| Find all Licenses in zip 06614 | |||
| City | STRATFORD |
| Zip Code | 06614 |
| License Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| License Type + County | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER + STRATFORD |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Shawna Leigh Albrycht | 16 Whistling Straits Drive, Southington, CT 06489-3323 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Donna Marie Marie Romito | 330 Washington St, Norwich, CT 06360 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Joy Marie Richardson | 19 Day St, Norwalk, CT 06854-4912 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Marie Dam | 86 Deer Run, Burlington, CT 06013-1815 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Marie E Didario | 31 Fox Run Ct, Newington, CT 06111-4579 | Controlled Substance Registration for Practitioner | 2015-03-01 ~ 2017-02-28 |
| Marie Sanford | 282 Washington St, Hartford, CT 06106-3322 | Controlled Substance Registration for Practitioner | 2019-10-22 ~ 2021-02-28 |
| Marie E Peddinghaus | 111 Park St Apt 3e, New Haven, CT 06511-5451 | Controlled Substance Registration for Practitioner | 2009-03-01 ~ 2011-02-28 |
| Marie A Mantelli | 5 Kennedy Dr, Putnam, CT 06260-1939 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Theresa Marie Ramponi | 928 Elm, New Haven, CT 06511 | Controlled Substance Registration for Practitioner | 2019-04-03 ~ 2021-02-28 |
| Anne Marie A Roe Md | 824 Palmer Rd Apt 3c, Bronxville, NY 10708-3318 | Controlled Substance Registration for Practitioner | 2009-03-01 ~ 2011-02-28 |
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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).