ELIZABETH JACK (Credential# 1558617) is licensed (Medication Administration Certification) with Connecticut Department of Consumer Protection. The license effective date is December 29, 2019. The license expiration date date is December 28, 2021. The license status is ACTIVE.
ELIZABETH JACK is licensed with the Department of Consumer Protection of Connecticut. The credential number is #DSMA.001805221. The credential type is medication administration certification. The effective date is December 29, 2019. The expiration date is December 28, 2021. The business address is 12 Vincent Place, Naugatuck, CT 06770. The current status is active.
| Licensee Name | ELIZABETH JACK |
| Credential ID | 1558617 |
| Credential Number | DSMA.001805221 |
| Credential Type | Medication Administration Certification |
| Business Address |
12 Vincent Place Naugatuck CT 06770 |
| Business Type | EMPLOYEE ONLY |
| Status | ACTIVE - CERTIFIED |
| Active | 1 |
| Issue Date | 2016-02-02 |
| Effective Date | 2019-12-29 |
| Expiration Date | 2021-12-28 |
| Refresh Date | 2020-01-22 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 1544069 | DSMA.001505221 | Medication Administration Certification | 2013-12-05 | 2015-12-29 - 2017-12-28 | INACTIVE |
| Street Address | 12 Vincent Place |
| City | Naugatuck |
| State | CT |
| Zip Code | 06770 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Mardiny Khvay | 152 Cherry St, Naugatuck, CT 06770 | Combination Nail Technician, Esthetician Or Eyelash Technici | 2020-06-27 ~ 2021-09-30 |
| Jennifer D Arsan-siemasko | 26 Seth Dr, Naugatuck, CT 06770 | Registered Nurse | 2020-05-01 ~ 2021-04-30 |
| Margaret R Berge | 375 May St, Naugatuck, CT 06770 | Master's Level Social Worker - Temporary Permit | 2020-06-26 ~ 2020-09-14 |
| Ilene Zayas | 38 Arch St., Naugatuck, CT 06770 | Medication Administration Certification | ~ |
| Paula M Coelho | 56 Jolie Road, Naugatuck, CT 06770 | Dental Hygienist | 2020-07-01 ~ 2021-06-30 |
| Shannen Grace Welz | 292 Spencer St, Naugatuck, CT 06770 | Esthetician | ~ |
| Tanjala M Samuels | 15 Lorann Circle, Naugatuck, CT 06770 | Licensed Practical Nurse | 2020-07-01 ~ 2021-06-30 |
| Andrea Lee Evans | 216 Spring Street Unit 17, Naugatuck, CT 06770 | Registered Nurse | 2020-07-01 ~ 2021-06-30 |
| Jay Haack | 589 High Street, Naugatuck, CT 06770 | Medication Administration Certification | 2018-07-12 ~ 2020-07-11 |
| Kathleen B Chiarella | 67 Melbourne St, Naugatuck, CT 06770 | Registered Nurse | 2020-08-01 ~ 2021-07-31 |
| Find all Licenses in zip 06770 | |||
| City | Naugatuck |
| Zip Code | 06770 |
| License Type | Medication Administration Certification |
| License Type + County | Medication Administration Certification + Naugatuck |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Lisa Jack | P.o. Box 185, So. Woodstock, CT 06267 | Medication Administration Certification | 2013-09-17 ~ 2015-09-16 |
| Jack Greenwood | 36 Linda Ave, Uncasville, CT 06382 | Medication Administration Certification | 2018-10-07 ~ 2020-10-06 |
| Jack Christenson Jr | P.o. Box 872, Roselle Rm 230, Southbury, CT 06488 | Medication Administration Certification | 2017-07-03 ~ 2019-07-02 |
| Jack Smith | 23 Route 6, Andover, CT 06232-1023 | Medication Administration Certification | 1995-11-03 ~ 1997-11-02 |
| Dylan Jack | 200 John Olds Dr, Manchester, CT 06040 | Medication Administration Certification | 2018-10-25 ~ 2020-10-24 |
| Ashton Jack | 22 Pine St, East Hartford, CT 06108 | Medication Administration Certification | 2019-01-19 ~ 2021-01-18 |
| Jack Robinson | 421 Main Street, Cromwell, CT 06416 | Medication Administration Certification | 2018-04-12 ~ 2020-04-11 |
| Jack Perry | 808 Four Rod Road P.o. Box 7333, Kensington, CT 06037 | Medication Administration Certification | 1998-03-10 ~ 2000-03-09 |
| Melody Jack | 433 Boston Post Rd, Westbrook, CT 06498 | Medication Administration Certification | 2015-12-22 ~ 2017-12-21 |
| Jack Mason | 156 Cross Roads, Waterford, CT 06385 | Medication Administration Certification | 2018-06-18 ~ 2020-06-17 |
Please comment or provide details below to improve the information on ELIZABETH JACK.
| 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).