KAISER PERMANENTE (Credential# 160983) is licensed (Controlled Substance Registration for Practitioner) with Connecticut Department of Consumer Protection. The license effective date is February 29, 2000. The license expiration date date is February 28, 2001. The license status is INACTIVE.
KAISER PERMANENTE is licensed with the Department of Consumer Protection of Connecticut. The credential number is #CSP.0017664. The credential type is controlled substance registration for practitioner. The effective date is February 29, 2000. The expiration date is February 28, 2001. The business address is 130 Hartford Rd, Manchester, CT 06040-5921. The current status is inactive.
| Licensee Name | KAISER PERMANENTE |
| Business Name | KAISER PERMANENTE |
| Credential ID | 160983 |
| Credential Number | CSP.0017664 |
| Credential Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| Business Address |
130 Hartford Rd Manchester CT 06040-5921 |
| Business Type | BUSINESS |
| Status | INACTIVE |
| Effective Date | 2000-02-29 |
| Expiration Date | 2001-02-28 |
| Refresh Date | 2009-01-26 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Kaiser Permanente | 299 Farmington Avenue, Farmington, CT 06032 | Controlled Substance Registration for Practitioner | 1993-12-06 ~ 1995-12-01 |
| Street Address | 130 HARTFORD RD |
| City | MANCHESTER |
| State | CT |
| Zip Code | 06040-5921 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Austin Bass | 130 Hartford Rd, Manchester, CT 06040-5921 | Resident Physician | 2019-07-01 ~ 2022-06-30 |
| Bliss Yoon | 130 Hartford Rd, Manchester, CT 06040-5921 | Physician/surgeon | 2020-06-01 ~ 2021-05-31 |
| Alexandra E Zacchera | 130 Hartford Rd, Manchester, CT 06040-5921 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Sabesan Karuppiah | 130 Hartford Rd, Manchester, CT 06040-5921 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Omobola Onikoyi | 130 Hartford Rd, Manchester, CT 06040-5921 | Resident Physician | 2018-07-01 ~ 2019-06-30 |
| Victor E Korang Md | 130 Hartford Rd, Manchester, CT 06040 | Physician/surgeon | 2010-06-01 ~ 2011-05-31 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| New Hope Manor Inc | 48 Hartford Rd, Manchester, CT 06040-5921 | Public Charity | 2011-12-01 ~ 2013-05-31 |
| Fuss & O'neill Inc | 146 Hartford Rd, Manchester, CT 06040-5921 | Joint Practice | 2020-05-01 ~ 2021-04-30 |
| 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 |
|---|---|---|---|
| Kaiser Permanente Pharmacy 329 | 4131 Geary Blvd Ste 112, San Francisco, CA 94118-3101 | Nonresident Pharmacy | 2019-06-27 ~ 2020-08-31 |
| Joe Marion Md | Kaiser Permanente, Windsor, CT 06095 | Controlled Substance Registration for Practitioner | 2000-02-29 ~ 2001-02-28 |
| Kaiser Permanente Pharmacy #985 | 9521 Dalen St, Downey, CA 90242-4847 | Nonresident Pharmacy | 2019-09-01 ~ 2020-08-31 |
| Suzie E Schuder Md · Kaiser Permanente | 780 Summer Street, Stamford, CT 06901 | Controlled Substance Registration for Practitioner | 1996-03-01 ~ 1997-02-28 |
| Kaiser Permanente Wa Mail Order Pharmacy | 2921 Naches Ave Sw, Renton, WA 98057-2617 | Nonresident Pharmacy | 2019-09-01 ~ 2020-08-31 |
| Kaiser Permanente Sterling Automated Refill Center | 22370 Davis Dr, Sterling, VA 20164-5367 | Nonresident Pharmacy | 2019-09-01 ~ 2020-08-31 |
| Lucia S Whie-grayson | Kaiser Permanente, Downey, CA 90241 | Physician/surgeon | 1999-11-12 ~ 2001-01-31 |
| Kathryn M Palmer | Kaiser Permanente, Falls Church, VA 22046 | Physician/surgeon | 2009-05-08 ~ 2010-06-30 |
| Theodore Bruno Md · C/o Kaiser Permanente | 5 Tarry Town Lane, Niantic, CT 06357 | Physician/surgeon | 2019-12-01 ~ 2020-11-30 |
| Kaiser Permanante | 2080 Silas Deane Hwy, Rocky Hill, CT 06067-2334 | Controlled Substance Registration for Practitioner | 1999-03-01 ~ 2000-02-28 |
Please comment or provide details below to improve the information on KAISER PERMANENTE.
| 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).