GORDON L BRODIE (Credential# 152673) 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.
GORDON L BRODIE is licensed with the Department of Consumer Protection of Connecticut. The credential number is #CSP.0003691. 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 73 Hampton Dr, Manchester, CT 06040-6767. The current status is active.
| Licensee Name | GORDON L BRODIE |
| Credential ID | 152673 |
| Credential Number | CSP.0003691 |
| Credential Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| Business Address |
73 Hampton Dr Manchester CT 06040-6767 |
| Business Type | INDIVIDUAL |
| Status | ACTIVE - CURRENT |
| Active | 1 |
| Issue Date | 1999-03-01 |
| Effective Date | 2019-03-01 |
| Expiration Date | 2021-02-28 |
| Refresh Date | 2018-12-28 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 542621 | 1.017993 | Physician/Surgeon | 1976-06-16 | 2019-11-01 - 2020-10-31 | ACTIVE |
| Street Address | 73 HAMPTON DR |
| City | MANCHESTER |
| State | CT |
| Zip Code | 06040-6767 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Mary Fosuah Nketia | 61 Cougar Drive, Manchester, CT 06040 | Registered Nurse | 2020-08-01 ~ 2021-07-31 |
| New Seasons Inc. | 164 East Center Street, Manchester, CT 06040 | Public Charity | 2019-06-01 ~ 2020-05-31 |
| Kaylen Lam | 60 Chlistone Lane, Manchester, CT 06040 | Combination Nail Technician, Esthetician Or Eyelash Technici | ~ |
| Matilde Altamirano | 415 Gardner Street, Manchester, CT 06040 | Nail Technician | 2020-06-27 ~ 2022-04-30 |
| Meilan Meilan Chen | 174 Middle Tpke, Manchester, CT 06040 | Nail Technician | ~ |
| Prince Acheampong | 32 Bigelow Street, Manchester, CT 06040 | Notary Public Appointment | ~ |
| Erin C Boyle | 470 Porter Street, Manchester, CT 06040 | Registered Nurse | 2020-07-01 ~ 2021-06-30 |
| Dejone Mitchell | 64 Ruby Dr Apt. P, Manchester, CT 06040 | Combination Nail Technician, Esthetician Or Eyelash Technici | ~ |
| Andrea H Clifford | 116 Longview Drive, Manchester, CT 06040 | Licensed Practical Nurse | 2020-09-01 ~ 2021-08-31 |
| Tabia Thornton-bey | 103 Walek Farms Road, Manchester, CT 06040 | Licensed Clinical Social Worker | 2020-07-01 ~ 2021-06-30 |
| Find all Licenses in zip 06040 | |||
| City | MANCHESTER |
| Zip Code | 06040 |
| License Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| License Type + County | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER + MANCHESTER |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Jessica S Gordon | 2 Talcott Gln, Farmington, CT 06032-3521 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Andrea E Gordon Md | 95 Columbus Pl #3, Stamford, CT 06907 | Controlled Substance Registration for Practitioner | 2002-03-01 ~ 2003-02-28 |
| Malcolm Gordon Md | 38 Harborview Ave, Norwalk, CT 06854 | Controlled Substance Registration for Practitioner | 2015-03-01 ~ 2017-02-28 |
| Mark R Powers Pa-c | 66 Gordon St, Hamden, CT 06517 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Roger N Fox | 2 Gordon Place, Middletown, CT 06457 | Controlled Substance Registration for Practitioner | 2007-03-13 ~ 2008-02-29 |
| Laurie A Gordon | 79 Lakewind Rd, New Canaan, CT 06840 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Rachel Gordon | 114 Woodland St, Hartford, CT 06105-1208 | Controlled Substance Registration for Practitioner | 2017-03-01 ~ 2019-02-28 |
| Gordon Goodman Md | 101 Academy St, Manlius, NY 13104 | Controlled Substance Registration for Practitioner | 2002-03-01 ~ 2003-02-28 |
| Michael E Gordon Jr | 35 Willard St Apt.6a, New Haven, CT 06515 | Controlled Substance Registration for Practitioner | 2007-03-01 ~ 2008-02-29 |
| Gordon C Pittard | 56 Franklin St, Waterbury, CT 06702 | Controlled Substance Registration for Practitioner | 2013-03-01 ~ 2015-02-28 |
Please comment or provide details below to improve the information on GORDON L BRODIE.
| 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).