AUSTIN BASS (Credential# 1663359) is licensed (Resident Physician) with Connecticut Department of Consumer Protection. The license effective date is July 1, 2019. The license expiration date date is June 30, 2022. The license status is ACTIVE.
AUSTIN BASS is licensed with the Department of Consumer Protection of Connecticut. The credential number is #1.063517-RES. The credential type is resident physician. The effective date is July 1, 2019. The expiration date is June 30, 2022. The business address is 130 Hartford Rd, Manchester, CT 06040-5921. The current status is active.
| Licensee Name | AUSTIN BASS |
| Credential ID | 1663359 |
| Credential Number | 1.063517-RES |
| Credential Type | Resident Physician |
| Credential SubCategory | RES |
| Business Address |
130 Hartford Rd Manchester CT 06040-5921 |
| Business Type | INDIVIDUAL |
| Status | ACTIVE - CURRENT |
| Active | 1 |
| Issue Date | 2019-07-01 |
| Effective Date | 2019-07-01 |
| Expiration Date | 2022-06-30 |
| Refresh Date | 2019-06-18 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 1647279 | CSP.0070637 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 2019-05-29 | 2019-05-29 - 2021-02-28 | ACTIVE |
| Street Address | 130 HARTFORD RD |
| City | MANCHESTER |
| State | CT |
| Zip Code | 06040-5921 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Bliss Yoon | 130 Hartford Rd, Manchester, CT 06040-5921 | Physician/surgeon | 2020-06-01 ~ 2021-05-31 |
| Alexandra E Zacchera | 130 Hartford Rd, Manchester, CT 06040-5921 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Sabesan Karuppiah | 130 Hartford Rd, Manchester, CT 06040-5921 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Omobola Onikoyi | 130 Hartford Rd, Manchester, CT 06040-5921 | Resident Physician | 2018-07-01 ~ 2019-06-30 |
| Victor E Korang Md | 130 Hartford Rd, Manchester, CT 06040 | Physician/surgeon | 2010-06-01 ~ 2011-05-31 |
| Kaiser Permanente | 130 Hartford Rd, Manchester, CT 06040-5921 | Controlled Substance Registration for Practitioner | 2000-02-29 ~ 2001-02-28 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| New Hope Manor Inc | 48 Hartford Rd, Manchester, CT 06040-5921 | Public Charity | 2011-12-01 ~ 2013-05-31 |
| Fuss & O'neill Inc | 146 Hartford Rd, Manchester, CT 06040-5921 | Joint Practice | 2020-05-01 ~ 2021-04-30 |
| 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 | Resident Physician |
| License Type + County | Resident Physician + MANCHESTER |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Princess Thomas | 1644 Bass Rd, Macon, GA 31210 | Resident Physician | 2015-06-29 ~ 2020-06-30 |
| Matthew R. Austin | 20 York St, New Haven, CT 06510 | Resident Physician | 2018-07-01 ~ 2019-06-30 |
| Austin John Mchenry | 20 York St, New Haven, CT 06510-3220 | Resident Physician | 2020-07-01 ~ 2021-06-30 |
| Austin Moats | 400 Blake St Apt 1105, New Haven, CT 06515-4427 | Resident Physician | 2020-07-01 ~ 2021-06-30 |
| Matthew Reber Austin | 20 York St, New Haven, CT 06510-3220 | Resident Physician | 2018-07-01 ~ 2021-06-30 |
| Robert L. Bass · Bass Home Electronics | 80 Bentwood Rd, West Hartford, CT 06107 | Electrical Limited Contractor | ~ |
| Samuel E Austin | 263 Farmington Avenue, Farmington, CT 06030-1921 | Resident Physician | 2019-07-01 ~ 2022-06-30 |
| Austin J Healy | 263 Farmington Ave, Farmington, CT 06030-0001 | Resident Physician | 2018-07-01 ~ 2024-06-30 |
| Frank R Bass · F R Bass Construction Co | 186 S Windham Rd, Willimantic, CT 06226 | Home Improvement Contractor | 2009-12-01 ~ 2010-11-30 |
| The Bass Farm | 135 Bass Rd, Windham, CT 06280-2202 | Milk Producer | 2013-07-01 ~ 2014-06-30 |
Please comment or provide details below to improve the information on AUSTIN BASS.
| 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).