JACKIE CHUONG (Credential# 154433) 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.
JACKIE CHUONG is licensed with the Department of Consumer Protection of Connecticut. The credential number is #CSP.0016895. 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 687 Main St, Branford, CT 06405-3612. The current status is active.
| Licensee Name | JACKIE CHUONG |
| Credential ID | 154433 |
| Credential Number | CSP.0016895 |
| Credential Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| Business Address |
687 Main St Branford CT 06405-3612 |
| 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 | 2019-06-13 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 543738 | 1.021572 | Physician/Surgeon | 1979-07-18 | 2020-02-01 - 2021-01-31 | ACTIVE |
| Street Address | 687 MAIN ST |
| City | BRANFORD |
| State | CT |
| Zip Code | 06405-3612 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Michael P Dorfman | 687 Main St, Branford, CT 06405-3612 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Digestive Disease Associates Endoscopy Suite, LLC | 687 Main St, Branford, CT 06405-3612 | Out-patient Surgical Facility | 2018-10-01 ~ 2020-09-30 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Wrsp LLC · Wrsp Referral Group LLC | 707 Main St, Branford, CT 06405-3612 | Real Estate Broker | 2016-04-01 ~ 2017-03-31 |
| Patricia A Johnson | 707 Main St, Branford, CT 06405-3612 | Real Estate Salesperson | 2013-06-01 ~ 2014-05-31 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Raymond M Johnson | 39 Bayberry Lane, Branford, CT 06405 | Physician/surgeon | 2020-07-01 ~ 2021-06-30 |
| Kirsten M Ranciato | 288 East Main Street, Branford, CT 06405 | Licensed Clinical Social Worker | 2020-08-01 ~ 2021-07-31 |
| Bimala Khadka Thapa | 726 Robert Frost Dr., Branford, CT 06405 | Nail Technician | ~ |
| Paul E Basile | 42 Valley Brook Road South, Branford, CT 06405 | Perfusionist | 2020-08-01 ~ 2021-07-31 |
| Lupe Monica Placencia-muy | 100 East Main Street 2nd Fl, Branford, CT 06405 | Combination Nail Technician, Esthetician Or Eyelash Technici | 2020-06-27 ~ 2022-02-28 |
| Bridget J Jennings | 159 Queach Road, Branford, CT 06405 | Registered Nurse | 2020-09-01 ~ 2021-08-31 |
| Ujeli Acharya | 21 Burban Drive, Branford, CT 06405 | Nail Technician | ~ |
| Cathleen Smith | 50 First Avenue, Branford, CT 06405 | Radiographer | 2020-07-01 ~ 2021-06-30 |
| Gita Thapa | 94 Village Lane, Branford, CT 06405 | Nail Technician | ~ |
| Cycle Venture Partners Fund I Lp - Lumeda Series 1 | 50 Limewood Avenue, Branford, CT 06405 | Securities - Exemptions | 2020-06-17 ~ |
| Find all Licenses in zip 06405 | |||
| City | BRANFORD |
| Zip Code | 06405 |
| License Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| License Type + County | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER + BRANFORD |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Anna Paula Rego | 45 Jackie Drive, Ludlow, MA 01056 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Jackie Celestin | 263 Farmington Ave Mc-1235, Farmington, CT 06030-1235 | Controlled Substance Registration for Practitioner | 2008-03-28 ~ 2009-02-28 |
| Jackie Gleason | Connecticut Brand Registration, Hartford, CT 06106 | Liquor Brand Label | 2018-06-25 ~ 2021-06-24 |
| 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 |
| Huu Duc D Luu | 630 Mix Ave Apt 6p, Hamden, CT 06514-2320 | Controlled Substance Registration for Practitioner | 2011-03-01 ~ 2013-02-28 |
| Qi Che Md | Bridgeport, CT 06610 | Controlled Substance Registration for Practitioner | 2006-03-01 ~ 2007-02-28 |
| Hae J Kim Pa | New Haven, CT 06511 | Controlled Substance Registration for Practitioner | 2008-03-31 ~ 2009-02-28 |
| Arundati Rao | CT | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Erin K Fee | CT | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
Please comment or provide details below to improve the information on JACKIE CHUONG.
| 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).