TERESA MARIA DOMACK (Credential# 1623387) is licensed (Controlled Substance Registration for Practitioner) with Connecticut Department of Consumer Protection. The license effective date is January 2, 2019. The license expiration date date is February 28, 2021. The license status is ACTIVE.
TERESA MARIA DOMACK is licensed with the Department of Consumer Protection of Connecticut. The credential number is #CSP.0070044. The credential type is controlled substance registration for practitioner. The effective date is January 2, 2019. The expiration date is February 28, 2021. The business address is 79 Bayberry Hill Rd, Avon, CT 06001-2800. The current status is active.
| Licensee Name | TERESA MARIA DOMACK |
| Credential ID | 1623387 |
| Credential Number | CSP.0070044 |
| Credential Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| Business Address |
79 Bayberry Hill Rd Avon CT 06001-2800 |
| Business Type | INDIVIDUAL |
| Status | ACTIVE - CURRENT |
| Active | 1 |
| Issue Date | 2019-01-02 |
| Effective Date | 2019-01-02 |
| Expiration Date | 2021-02-28 |
| Refresh Date | 2019-01-03 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 1614187 | 1.062215 | Physician/Surgeon | 2018-12-31 | 2019-12-01 - 2020-11-30 | ACTIVE |
| Street Address | 79 BAYBERRY HILL RD |
| City | AVON |
| State | CT |
| Zip Code | 06001-2800 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Rafael S Wurzel | 77 Bayberry Hill Rd, Avon, CT 06001-2800 | Physician/surgeon | 2020-07-01 ~ 2021-06-30 |
| Jacenda O'dwyer | 85 Bayberry Hill Rd, Avon, CT 06001-2800 | Emergency Medical Technician | 2020-03-31 ~ 2021-12-31 |
| Christopher Aiudi | 20 Bayberry Hill Rd, Avon, CT 06001-2800 | Public Weigher | 2015-08-25 ~ 2016-06-30 |
| Satesh C Singh | 83 Bayberry Hill Rd, Avon, CT 06001-2800 | Physician/surgeon | 2017-07-01 ~ 2018-06-30 |
| Tsunami Drive.org | 83 Bayberry Hill Rd, Avon, CT 06001-2800 | Public Charity-exempt From Financial Requirements | ~ |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Julie R Deitch | 5 Bridle Path, Avon, CT 06001 | Dental Hygienist | 2020-07-01 ~ 2021-06-30 |
| Brigitte Nicole Heleniak | 16 Sunset Trail, Avon, CT 06001 | Registered Nurse | 2020-07-01 ~ 2021-06-30 |
| Coffee Trade Inc (the) | 21 West Main St, Avon, CT 06001 | Operator of Weighing & Measuring Devices | 2020-08-01 ~ 2021-07-31 |
| Elizabeth Stockwell | 44 Applewood Lane, Avon, CT 06001 | Real Estate Salesperson | ~ |
| Mollie Velma Lahaie | 14 Red Mountain Lane, Avon, CT 06001 | Registered Nurse | 2020-06-26 ~ 2020-08-31 |
| Meiling Chen | Avon Nail 315 W Main Street, Avon, CT 06001 | Nail Technician | ~ |
| Richard J Kaiser | 72 Westland Road, Avon, CT 06001 | Architect | 2020-08-01 ~ 2021-07-31 |
| Michele L Sweitzer | 12 Bluestone Lane, Avon, CT 06001 | Real Estate Salesperson | 2020-06-25 ~ 2021-05-31 |
| Caroline O Amin | 5 Colby Way, Avon, CT 06001 | Physician/surgeon | 2020-08-01 ~ 2021-07-31 |
| Christine Burns | 102 New Road, Avon, CT 06001 | Registered Nurse | 2020-08-01 ~ 2021-07-31 |
| Find all Licenses in zip 06001 | |||
| City | AVON |
| Zip Code | 06001 |
| License Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| License Type + County | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER + AVON |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Teresa M Domack | 79 Bayberry Hill Road, Avon, CT 06001 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Maria Teresa Perez Carballo | 152 Temple St Apt 607, New Haven, CT 06510-2613 | Controlled Substance Registration for Practitioner | 2019-01-24 ~ 2019-02-28 |
| Teresa A Martinez | 198 Brookdale Rd, Stamford, CT 06903-4130 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Teresa L Smith | 13 Egypt Ln, Clinton, CT 06413-2514 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Teresa Bremner Md | 19 Locust Ln, Farmington, CT 06032 | Controlled Substance Registration for Practitioner | 2001-03-01 ~ 2002-02-28 |
| Teresa M Love Dvm | 451 River Rd, Willington, CT 06279-1332 | Controlled Substance Registration for Practitioner | 2011-03-01 ~ 2013-02-28 |
| Teresa Sheetz | 17 Southridge Rd, Prospect, CT 06712 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Teresa K Spencer | 26 Homestead Ave, Derby, CT 06418-2516 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Teresa T Lee Md | 1 Goodwin Place, Avon, CT 06001 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Teresa A Ponn | 616 Kearney Circle, Manchester, NH 03104 | Controlled Substance Registration for Practitioner | 2007-03-01 ~ 2008-02-29 |
Please comment or provide details below to improve the information on TERESA MARIA DOMACK.
| 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).