DWALA GIBSON (Credential# 1530411) 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.
DWALA GIBSON is licensed with the Department of Consumer Protection of Connecticut. The credential number is #CSP.0069047. 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 Po Box 3260, Mashantucket, CT 06338-3260. The current status is active.
| Licensee Name | DWALA GIBSON |
| Credential ID | 1530411 |
| Credential Number | CSP.0069047 |
| Credential Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| Business Address |
Po Box 3260 Mashantucket CT 06338-3260 |
| Business Type | INDIVIDUAL |
| Status | ACTIVE - CURRENT |
| Active | 1 |
| Issue Date | 2018-07-16 |
| Effective Date | 2019-03-01 |
| Expiration Date | 2021-02-28 |
| Refresh Date | 2019-04-30 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 1503865 | 10.149971 | Registered Nurse | 2018-04-26 | 2020-01-01 - 2020-12-31 | ACTIVE |
| 1503876 | 12.007608 | Advanced Practice Registered Nurse | 2018-06-10 | 2020-01-01 - 2020-12-31 | ACTIVE |
| 1503932 | 10.149663-TEMP | Registered Nurse - Temporary | 2018-04-10 | 2018-04-10 - 2018-04-26 | INACTIVE |
| Street Address | PO BOX 3260 |
| City | MASHANTUCKET |
| State | CT |
| Zip Code | 06338-3260 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Clinton Coleman · California Pizza Kitchen | 39 Norwich Westerly Rd, Mashantucket, CT 06338 | Restaurant Liquor | 2020-09-14 ~ 2022-01-13 |
| Brianna Antwanette Latham | P O Box 3195, Mashantucket, CT 06338 | Casino Class I Employee | 2020-04-30 ~ 2020-10-31 |
| Christopher John Levi Quintero | 3423 P O Box, Mashantucket, CT 06338 | Casino Class I Employee | 2020-04-23 ~ 2020-10-31 |
| Jason E Nichols · Shrine/red Lantern | 240 Fox Tower Dr, Mashantucket, CT 06338 | Cafe Liquor | 2019-09-26 ~ 2021-01-25 |
| Michael Schlow · Alta Strada | 39 Norwich-westerly Rd, Mashantucket, CT 06338 | Restaurant Liquor | 2020-02-03 ~ 2021-06-02 |
| Stan Harris, IIi | P.o. Box 3249, Mashantucket, CT 06338 | Water Treatment Plant Operator - Class I | 2016-10-01 ~ 2019-09-30 |
| James D. Walker | Po Box 3123, Mashantucket, CT 06338 | Casino Class I Employee | 2019-12-11 ~ 2020-10-31 |
| Anita D. Valdez | Po Box 3423, Mashantucket, CT 06338 | Casino Class I Employee | 2019-12-11 ~ 2020-10-31 |
| Theodore A. Corprew-sebastian | 3 Ann Wampee, Mashantucket, CT 06338 | Casino Class I Employee | 2019-12-11 ~ 2020-10-31 |
| Christina Marie Morrissette | P O Box 3003, Mashantucket, CT 06338 | Casino Class I Employee | 2019-12-18 ~ 2020-10-31 |
| Find all Licenses in zip 06338 | |||
| City | MASHANTUCKET |
| Zip Code | 06338 |
| License Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| License Type + County | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER + MASHANTUCKET |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Andrew M Gibson | 24 Hospital Ave, Danbury, CT 06810-6099 | Controlled Substance Registration for Practitioner | 2013-03-01 ~ 2015-02-28 |
| Pamela Gibson | 10 John St, Southport, CT 06890 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Efthimia Koliais | 17 Gibson Ln, Middletown, CT 06457-8732 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Erica L Gibson | 20 Vera St Apt 4, West Hartford, CT 06119-1952 | Controlled Substance Registration for Practitioner | 2017-03-01 ~ 2019-02-28 |
| Sai P Haranath Md | 6210 Gibson Ln Apt 3202, Texarkana, TX 75503-1249 | Controlled Substance Registration for Practitioner | 2011-03-01 ~ 2013-02-28 |
| David H Gibson Md | Yale School of Medicine, New Haven, CT 06519 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Douglas W Gibson | 80 Jackson Cove Road, Oxford, CT 06478 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Steven Kassels Md · Community Substance Abuse Center | Comm. Physicians PC/125 North Elm Street, Westfield, MA 01085 | Controlled Substance Registration for Practitioner | 2018-06-15 ~ 2019-02-28 |
| Shu-i Lin | CT | Controlled Substance Registration for Practitioner | 2017-06-12 ~ 2019-02-28 |
| Min Jin Kim | 639 4th Ave Apt 5c, Brooklyn, NY 11232-1048 | Controlled Substance Registration for Practitioner | 2012-05-10 ~ 2013-02-28 |
Please comment or provide details below to improve the information on DWALA GIBSON.
| 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).