JACK M LEVINE (Credential# 1634544) is licensed (Controlled Substance Registration for Practitioner) with Connecticut Department of Consumer Protection. The license effective date is February 28, 2019. The license expiration date date is February 28, 2021. The license status is ACTIVE.
JACK M LEVINE is licensed with the Department of Consumer Protection of Connecticut. The credential number is #CSP.0070334. The credential type is controlled substance registration for practitioner. The effective date is February 28, 2019. The expiration date is February 28, 2021. The business address is 375 Orange St, New Haven, CT 06511-6406. The current status is active.
| Licensee Name | JACK M LEVINE |
| Credential ID | 1634544 |
| Credential Number | CSP.0070334 |
| Credential Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| Business Address |
375 Orange St New Haven CT 06511-6406 |
| Business Type | INDIVIDUAL |
| Status | ACTIVE - CURRENT |
| Active | 1 |
| Issue Date | 2019-02-28 |
| Effective Date | 2019-02-28 |
| Expiration Date | 2021-02-28 |
| Refresh Date | 2019-02-28 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 700586 | 2.004665 | Dentist | 1974-02-16 | 2019-10-01 - 2020-09-30 | ACTIVE |
| 393468 | CSP.0036924 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 2004-01-11 | 2015-03-01 - 2017-02-28 | INACTIVE |
| Street Address | 375 ORANGE ST |
| City | NEW HAVEN |
| State | CT |
| Zip Code | 06511-6406 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Thomas G Campbell | 389 Orange St, New Haven, CT 06511-6406 | Licensed Clinical Social Worker | 2019-12-01 ~ 2020-11-30 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Montessori School On Edgewood Inc. | 230 Edgewood Avenue, New Haven, CT 06511 | Public Charity | 2019-06-01 ~ 2020-05-31 |
| Therese Parks · Visel Drug Store | 264 Munson St, New Haven, CT 06511 | Registered Nurse | 2020-07-01 ~ 2021-06-30 |
| Dazjia Monet Green | 115 Edgewood Ave Apt 64, New Haven, CT 06511 | Registered Nurse | 2020-06-27 ~ 2021-05-31 |
| Carol Yam | 343 Humphrey St, New Haven, CT 06511 | Registered Nurse | ~ |
| Marwan S Haddad | 38 Lincoln Street, New Haven, CT 06511 | Physician/surgeon | 2020-07-01 ~ 2021-06-30 |
| Mary Lou Gaeta Md | 558 Chapel Street, New Haven, CT 06511 | Physician/surgeon | 2020-07-01 ~ 2021-06-30 |
| Cary M Tucker | 64 Bishop St, New Haven, CT 06511 | Architect | 2020-08-01 ~ 2021-07-31 |
| Frank J Pannenborg | 505 Ellsworth Ave, New Haven, CT 06511 | Architect | 2020-08-01 ~ 2021-07-31 |
| Crystal E Gooding | 26 Woodland Street, New Haven, CT 06511 | Notary Public Appointment | 2020-07-01 ~ 2025-06-30 |
| Kieran Jones | 260 Crown St Unit 1f, New Haven, CT 06511 | Registered Nurse | ~ |
| Find all Licenses in zip 06511 | |||
| City | NEW HAVEN |
| Zip Code | 06511 |
| License Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| License Type + County | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER + NEW HAVEN |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Jack E Levine Md | 6 Nancy Lane, Chappaqua, NY 10514 | Controlled Substance Registration for Practitioner | 2004-02-29 ~ 2005-02-28 |
| Jack Zazzaro, D.m.d. | 316 Main St S Ste D, Southbury, CT 06488-4238 | Controlled Substance Registration for Practitioner | 2016-03-14 ~ 2017-02-28 |
| Howard Levine Dvm | Po Box 87, S Woodstock, CT 06267 | Controlled Substance Registration for Practitioner | 2008-03-01 ~ 2009-02-28 |
| William Levine Dpm | 32 Cherry St, Milford, CT 06460 | Controlled Substance Registration for Practitioner | 1993-09-27 ~ 1995-03-01 |
| Robert A Levine | 41 Rayfield Rd, Westport, CT 06880-4526 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Sara B Levine Md | 45 Tisdale Rd, Scarsdale, NY 10583-5630 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| John B Levine Md | 55 Blossom St Rm 405, Boston, MA 02114-2602 | Controlled Substance Registration for Practitioner | 2011-03-01 ~ 2013-02-28 |
| Michael C Levine Dmd | 20 Hartford Rd, Salem, CT 06420 | Controlled Substance Registration for Practitioner | 2006-03-01 ~ 2007-02-28 |
| Joshua L Levine | 545 W 110th St Apt 11c, New York, NY 10025-2045 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Reed Levine Md | 56 Franklin St, Waterbury, CT 06706 | 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).