ANTHONY DISTEFANO MD (Credential# 158837) 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.
ANTHONY DISTEFANO MD is licensed with the Department of Consumer Protection of Connecticut. The credential number is #CSP.0020016. 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 360 Tolland Tpke Ste 3b, Manchester, CT 06042-1770. The current status is active.
| Licensee Name | ANTHONY DISTEFANO MD |
| Credential ID | 158837 |
| Credential Number | CSP.0020016 |
| Credential Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| Business Address |
360 Tolland Tpke Ste 3b Manchester CT 06042-1770 |
| 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 |
|---|---|---|---|---|---|
| 549815 | 1.032190 | Physician/Surgeon | 1992-04-10 | 2020-01-01 - 2020-12-31 | ACTIVE |
| Street Address | 360 TOLLAND TPKE STE 3B |
| City | MANCHESTER |
| State | CT |
| Zip Code | 06042-1770 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| David J Rosenberg | 360 Tolland Tpke Ste 3b, Manchester, CT 06042-1770 | Physician/surgeon | 2020-09-01 ~ 2021-08-31 |
| John Griffith | 360 Tolland Tpke Ste 3b, Manchester, CT 06042-1770 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Arthur E Lamontagne Jr | 360 Tolland Tpke Ste 3b, Manchester, CT 06042-1770 | Controlled Substance Registration for Practitioner | 2015-03-01 ~ 2017-02-28 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| May Institute Inc | 360 Tolland Tpke Ste 2f, Manchester, CT 06042-1770 | Public Charity | 2020-06-01 ~ 2021-05-31 |
| Donna M Boccelli Dpm | 360 Tolland Tpke Ste 2c, Manchester, CT 06042-1770 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Melissa Aiello | 118 Tudor Lane Apt. I, Manchester, CT 06042 | Licensed Clinical Social Worker | 2020-07-01 ~ 2021-06-30 |
| Michelle Carolyn Hayes | 129 Rachel Rd, Harford, CT 06042 | Combination Nail Technician, Esthetician Or Eyelash Technici | ~ |
| Guotong Quan | 348 Kennedy Road, 348 Kennedy Road, CT 06042 | Nail Technician | 2020-06-26 ~ 2022-03-31 |
| Charity Boakye | 103 Rachel Rd,unit B, Manchester, CT 06042 | Licensed Practical Nurse | ~ |
| Jordan M Kaiser | 40 Tanner St, Manchester, CT 06042 | Registered Nurse | 2020-06-01 ~ 2021-05-31 |
| Tandra Gomes | 80 Alton St., Manchester, CT 06042 | Medication Administration Certification | 2020-05-08 ~ 2022-05-07 |
| James Power | 16 Lawton Rd., Manchester, CT 06042 | Medication Administration Certification | 2018-08-03 ~ 2020-08-02 |
| Tierra Amerson | 66 Phelps Rd., Manchester, CT 06042 | Medication Administration Certification | 2018-07-02 ~ 2020-07-01 |
| Lisa A Surdam | 22 Greenwood Drive, Manchester, CT 06042 | Notary Public Appointment | 2020-06-01 ~ 2025-05-31 |
| Sharon Morin | 15 Hartland Rd, Manchester, CT 06042 | Hairdresser/cosmetician | 2020-09-01 ~ 2022-08-31 |
| Find all Licenses in zip 06042 | |||
| City | MANCHESTER |
| Zip Code | 06042 |
| License Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| License Type + County | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER + MANCHESTER |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| John Distefano Jr | 150 Sycamore St, Glastonbury, CT 06033 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Francis Samuel Distefano | 27 N 7th St Apt 225, Allentown, PA 18101-1360 | Controlled Substance Registration for Practitioner | 2019-05-16 ~ 2021-02-28 |
| Alberto G Distefano | Yale Eye Center, New Haven, CT 06510 | Controlled Substance Registration for Practitioner | 2017-03-01 ~ 2019-02-28 |
| Nicholas J Distefano | 150 Sycamore Street, Glastonbury, CT 06033 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Jessica D Distefano | 360 State Street, New Haven, CT 06510 | Controlled Substance Registration for Practitioner | 2015-03-01 ~ 2017-02-28 |
| Edward Distefano · Ed Distefano & Son | 529 Middlebury Rd, Watertown, CT 06795 | Home Improvement Contractor | 1995-06-17 ~ 1995-11-30 |
| Anthony J Onofreo | 141 Coe Ave, Middletown, CT 06457-4732 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Anthony C. Giannuzzi | 39 Mimosa Dr, Cos Cob, CT 06807-1402 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Anthony Ndu | 167 Wooster St Apt 2, New Haven, CT 06511 | Controlled Substance Registration for Practitioner | 2010-12-07 ~ 2013-02-28 |
| Anthony J Russo Dds | 85 Prospect St, Milford, CT 06460 | Controlled Substance Registration for Practitioner | 2007-03-01 ~ 2008-02-29 |
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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).