S WALTER WITRYOL (Credential# 1656236) is licensed (Physician/surgeon) with Connecticut Department of Consumer Protection. The license effective date is March 1, 2020. The license expiration date date is February 28, 2021. The license status is ACTIVE.
S WALTER WITRYOL is licensed with the Department of Consumer Protection of Connecticut. The credential number is #1.063984. The credential type is physician/surgeon. The effective date is March 1, 2020. The expiration date is February 28, 2021. The business address is 29 Haynes St Ste D, Manchester, CT 06040-4139. The current status is active.
| Licensee Name | S WALTER WITRYOL |
| Credential ID | 1656236 |
| Credential Number | 1.063984 |
| Credential Type | Physician/Surgeon |
| Business Address |
29 Haynes St Ste D Manchester CT 06040-4139 |
| Business Type | INDIVIDUAL |
| Status | ACTIVE - CURRENT |
| Active | 1 |
| Issue Date | 2019-07-17 |
| Effective Date | 2020-03-01 |
| Expiration Date | 2021-02-28 |
| Refresh Date | 2020-01-27 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 1676512 | CSP.0071978 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 2019-07-18 | 2019-07-18 - 2021-02-28 | ACTIVE |
| Street Address | 29 HAYNES ST STE D |
| City | MANCHESTER |
| State | CT |
| Zip Code | 06040-4139 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Anthony M King | 29 Haynes St Ste D, Manchester, CT 06040-4139 | Controlled Substance Registration for Practitioner | 2017-05-30 ~ 2019-02-28 |
| 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 | Physician/Surgeon |
| License Type + County | Physician/Surgeon + MANCHESTER |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Walter G Donnelly Jr | Po Box 679, Sharon, CT 06069-0679 | Physician/surgeon | 2014-08-01 ~ 2015-07-31 |
| Walter A Castro | 282 Washington St, Hartford, CT 06106-3322 | Physician/surgeon | ~ |
| Walter P Reyelt Jr | Po Box 206, Sharon, CT 06069-0206 | Physician/surgeon | 2020-05-01 ~ 2021-04-30 |
| Walter R Kope | 162 Mountain Rd, Suffield, CT 06078 | Physician/surgeon | 2016-10-01 ~ 2017-09-30 |
| Walter D Lehnhoff | 7 Orchard Ln, Simsbury, CT 06070 | Physician/surgeon | 2020-05-01 ~ 2021-04-30 |
| Walter J Hierholzer Jr | 210 Dromara Rd, Guilford, CT 06437 | Physician/surgeon | 2009-06-01 ~ 2010-05-31 |
| Walter H Short | 85 Jefferson St, Hartford, CT 06106-2601 | Physician/surgeon | 1980-07-02 ~ 1981-06-30 |
| Walter Kulczycky Md | 24 Mulberry Rd, Woodbridge, CT 06525 | Physician/surgeon | 2006-02-13 ~ 2007-04-30 |
| Walter Mathis | 34 Park St., New Haven, CT 06519 | Physician/surgeon | 2020-07-01 ~ 2021-06-30 |
| Walter T Shanley | 279 South Trl # A, Stratford, CT 06614-8107 | Physician/surgeon | 2019-04-01 ~ 2020-03-31 |
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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).