MARK GERARD AMIRAULT (Credential# 1643327) is licensed (Controlled Substance Registration for Practitioner) with Connecticut Department of Consumer Protection. The license effective date is May 29, 2019. The license expiration date date is February 28, 2021. The license status is ACTIVE.
MARK GERARD AMIRAULT is licensed with the Department of Consumer Protection of Connecticut. The credential number is #CSP.0070536. The credential type is controlled substance registration for practitioner. The effective date is May 29, 2019. The expiration date is February 28, 2021. The business address is 71 Haynes St, Manchester, CT 06040-4131. The current status is active.
| Licensee Name | MARK GERARD AMIRAULT |
| Credential ID | 1643327 |
| Credential Number | CSP.0070536 |
| Credential Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| Business Address |
71 Haynes St Manchester CT 06040-4131 |
| Business Type | INDIVIDUAL |
| Status | ACTIVE - CURRENT |
| Active | 1 |
| Issue Date | 2019-05-29 |
| Effective Date | 2019-05-29 |
| Expiration Date | 2021-02-28 |
| Refresh Date | 2019-05-30 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 1663364 | 1.063522-RES | Resident Physician | 2019-07-01 | 2019-07-01 - 2020-06-30 | ACTIVE |
| Street Address | 71 HAYNES ST |
| City | MANCHESTER |
| State | CT |
| Zip Code | 06040-4131 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Tahir Mohammad Chaudhry | 71 Haynes St, Manchester, CT 06040-4131 | Resident Physician | 2019-07-01 ~ 2022-06-30 |
| Tracey L Carpenter | 71 Haynes St, Manchester, CT 06040-4131 | Pharmacist | 2020-02-01 ~ 2022-01-31 |
| Darci Moran Pa | 71 Haynes St, Manchester, CT 06040 | Physician Assistant | 2020-06-01 ~ 2021-05-31 |
| Sean M. Mclaughlin Md | 71 Haynes St, Manchester, CT 06040-4188 | Physician/surgeon | 2020-06-01 ~ 2021-05-31 |
| Amee Mehta | 71 Haynes St, Manchester, CT 06040 | Physician/surgeon | 2020-05-01 ~ 2021-04-30 |
| Megan T. Cummings | 71 Haynes St, Manchester, CT 06040-4131 | Physician/surgeon | 2020-05-01 ~ 2021-04-30 |
| Paul Allen Schwiger Jr | 71 Haynes St, Manchester, CT 06040-4131 | Physician/surgeon | 2020-04-01 ~ 2021-03-31 |
| Amanda Lu | 71 Haynes St, Manchester, CT 06040-4131 | Controlled Substance Registration for Practitioner | 2019-05-29 ~ 2021-02-28 |
| Mehdi Momen | 71 Haynes St, Manchester, CT 06040-4131 | Controlled Substance Registration for Practitioner | 2019-05-20 ~ 2021-02-28 |
| Minoo Hollis | 71 Haynes St, Manchester, CT 06040-4131 | Controlled Substance Registration for Practitioner | 2019-03-21 ~ 2021-02-28 |
| Find all Licenses in the same address | |||
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Keri Lee Pinnock | 353 Main Street, Manchester, CT 06040-4131 | Physician/surgeon | 2020-05-01 ~ 2021-04-30 |
| Dominique Kalil Md | 71 Haynes St Rm 1209, Manchester, CT 06040-4131 | Controlled Substance Registration for Practitioner | 2013-03-01 ~ 2015-02-28 |
| 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 |
|---|---|---|---|
| Gerard M Roy | 1 Grove St Fl 2, New Britain, CT 06053-4116 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Gerard S Mason | 8 Bayberry Ct, Cromwell, CT 06416-1766 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Gerard Sanacora Md | 21 Arrowhead Dr, Guilford, CT 06437 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Gerard J Muro Md | 4 Corporate Dr Ste 182, Shelton, CT 06484-6263 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Tamara L Jessiman Lnm | 31 Gerard St, Manchester, CT 06040 | Controlled Substance Registration for Practitioner | 2004-02-29 ~ 2005-02-28 |
| Gerard Fumo | 435 Lewis Ave Ste 220, Meriden, CT 06451-2101 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Jody Gerard | 4 Overview Dr, Easton, CT 06612-2059 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Gerard Mccloskey Md | 127 Turtle Bay Dr, Branford, CT 06405-4981 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Kenneth W Gerard | 8 Aquamarine Dr, Key West, FL 33040-5601 | Controlled Substance Registration for Practitioner | 2015-03-01 ~ 2017-02-28 |
| Gerard Burrow Md | 110 Deepwood Dr, Hamden, CT 06517 | Controlled Substance Registration for Practitioner | 2011-03-01 ~ 2013-02-28 |
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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).