MARK MOSS MD (Credential# 161160) is licensed (Controlled Substance Registration for Practitioner) with Connecticut Department of Consumer Protection. The license effective date is March 1, 1999. The license expiration date date is February 28, 2000. The license status is INACTIVE.
MARK MOSS MD is licensed with the Department of Consumer Protection of Connecticut. The credential number is #CSP.0023353. The credential type is controlled substance registration for practitioner. The effective date is March 1, 1999. The expiration date is February 28, 2000. The business address is 11 Fairlawn Avenue, Branford, CT 06405. The current status is inactive.
| Licensee Name | MARK MOSS MD |
| Credential ID | 161160 |
| Credential Number | CSP.0023353 |
| Credential Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| Business Address |
11 Fairlawn Avenue Branford CT 06405 |
| Business Type | INDIVIDUAL |
| Status | INACTIVE |
| Effective Date | 1999-03-01 |
| Expiration Date | 2000-02-28 |
| Refresh Date | 2009-01-26 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 552232 | 1.034636 | Physician/Surgeon | 1995-06-30 | 1998-11-06 - 1999-12-31 | INACTIVE |
| Street Address | 11 FAIRLAWN AVENUE |
| City | BRANFORD |
| State | CT |
| Zip Code | 06405 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Fernando David Burstein | 11 Fairlawn Avenue, Branford, CT 06405 | Physician/surgeon | 1986-07-01 ~ 1987-04-30 |
| 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 |
|---|---|---|---|
| Kristie Moss | Stamford Hospital Pob #9317, Stamford, CT 06904 | Controlled Substance Registration for Practitioner | 2007-03-01 ~ 2008-02-29 |
| Jacquelyn E Moss | 196 Foster St, New Haven, CT 06511-2543 | Controlled Substance Registration for Practitioner | 2013-03-01 ~ 2015-02-28 |
| Jin Jiang Dds | 670 Moss Farms Rd, Cheshire, CT 06410-1964 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Rex S Moss Md | 10 Taddei Court, Oakdale, CT 06370 | Controlled Substance Registration for Practitioner | 2011-03-01 ~ 2013-02-28 |
| Zhen Wang | 670 Moss Farms Rd, Cheshire, CT 06410-1964 | Controlled Substance Registration for Practitioner | 2008-08-22 ~ 2009-02-28 |
| Kwabena Amponsah | 10524 Moss Park Rd Ste 204, Orlando, FL 32832-5801 | Controlled Substance Registration for Practitioner | 2019-09-18 ~ 2021-02-28 |
| Kerry M Moss Md | 3 Ruthies Lane, West Simsbury, CT 06092 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Isaac L. Moss Md | Uconn Musculoskeletal Institute, Farmington, CT 06030-4037 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Sundeep Kumar Ram | 12666 Moss Park Ridge Dr, Orlando, FL 32832-7084 | Controlled Substance Registration for Practitioner | 2019-02-20 ~ 2021-02-28 |
| Jason E Moss | Stamford Hospital-dept.of Surgery, New Haven, CT 06902 | Controlled Substance Registration for Practitioner | 2005-03-01 ~ 2006-02-28 |
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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).