AUTUMN SMITH (Credential# 1667980) is licensed (Controlled Substance Registration for Practitioner) with Connecticut Department of Consumer Protection. The license effective date is June 11, 2019. The license expiration date date is February 28, 2021. The license status is ACTIVE.
AUTUMN SMITH is licensed with the Department of Consumer Protection of Connecticut. The credential number is #CSP.0071522. The credential type is controlled substance registration for practitioner. The effective date is June 11, 2019. The expiration date is February 28, 2021. The business address is 1 Denslow Rd, East Longmeadow, MA 01028-3104. The current status is active.
| Licensee Name | AUTUMN SMITH |
| Credential ID | 1667980 |
| Credential Number | CSP.0071522 |
| Credential Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| Business Address |
1 Denslow Rd East Longmeadow MA 01028-3104 |
| Business Type | INDIVIDUAL |
| Status | ACTIVE - CURRENT |
| Active | 1 |
| Issue Date | 2019-06-11 |
| Effective Date | 2019-06-11 |
| Expiration Date | 2021-02-28 |
| Refresh Date | 2019-06-13 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 1662451 | 23.004474 | Physician Assistant | 2019-06-06 | 2019-12-01 - 2020-11-30 | ACTIVE |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Autumn Smith | 95 Oak Ridge Drive, New Haven, CT 06513 | Medication Administration Certification | 2018-12-31 ~ 2020-12-30 |
| Street Address | 1 DENSLOW RD |
| City | EAST LONGMEADOW |
| State | MA |
| Zip Code | 01028-3104 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Lynda M Bishop | 1 Denslow Rd, East Longmeadow, MA 01028-3104 | Occupational Therapist | 2019-08-01 ~ 2021-07-31 |
| Nicole Michelle Calder | 1 Denslow Rd, East Longmeadow, MA 01028 | Physician Assistant | 2019-08-30 ~ 2020-05-31 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Kathleen Stezko | 29 Autumn Ridge, East Longmeadow, MA 01028 | Registered Nurse | 2020-09-01 ~ 2021-08-31 |
| Sergy Chebotarev | 38 Lenox Circle, East Longmeadow, MA 01028 | Tax Preparer/facilitator Permit | 2020-06-18 ~ 2022-06-30 |
| Breanna Lynn Cloonan | 11 Acorn Street, East Longmeadow, MA 01028 | Physical Therapist Assistant | 2020-07-01 ~ 2021-06-30 |
| Maureen Teresa Blanchard | 70 Somers Rd, East Longmeadow, MA 01028 | Esthetician | ~ |
| Erica J Mcnamara | 30 Villanova Street, East Longmeadow, MA 01028 | Real Estate Salesperson | 2020-06-15 ~ 2021-05-31 |
| Jerry E Gray | C/o Abide Inc., East Longmeadow, MA 01028 | Lead Abatement Supervisor | 2020-09-01 ~ 2021-08-31 |
| Devin T Mccorison | C/o Abide, Inc., East Longmeadow, MA 01028 | Asbestos Abatement Supervisor | 2020-09-01 ~ 2021-08-31 |
| Susan B Chunyk | Hampden Hearing Ctr, East Longmeadow, MA 01028 | Audiologist | 2020-08-01 ~ 2021-07-31 |
| Mario Tascon | 202 Canterbury Circle, East Longmeadow, MA 01028 | Real Estate Salesperson | 2020-06-08 ~ 2021-05-31 |
| Jeong Ja Lee | 25 Robin St, East Longmeadow, MA 01028 | Combination Nail Technician, Esthetician Or Eyelash Technici | ~ |
| Find all Licenses in zip 01028 | |||
| City | EAST LONGMEADOW |
| Zip Code | 01028 |
| License Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| License Type + County | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER + EAST LONGMEADOW |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Dana E Andreo | 103 Autumn Dr, Tolland, CT 06084-3817 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Sarah Mcallister | 32 Autumn Ln, New Canaan, CT 06840-6346 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Jamie Parece | 2 Autumn Road, Medway, MA 02053 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Judith L Carbonella | 75 Autumn Court, Cheshire, CT 06410 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Rachana A Sangani Dds | 407 Autumn Chase, Ellington, CT 06029-3728 | Controlled Substance Registration for Practitioner | 2006-03-01 ~ 2007-02-28 |
| Shamim Najeebi Md | 205 Autumn Chase, Ellington, CT 06029 | Controlled Substance Registration for Practitioner | 2001-03-01 ~ 2002-02-28 |
| Danute Banelis | 4506 Autumn Leaves Trl Se, Decatur, AL 35603-5341 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Dorey E Tilton Aprn | 2 Autumn Court, Northford, CT 06472-1619 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Linda M Hricz Borges Pa | 39 Autumn Ridge Rd, Huntington, CT 06484 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Lynne L Becker Dvm | 6440 Autumn Woods Blvd, Naples, FL 34109-7806 | Controlled Substance Registration for Practitioner | 2013-03-01 ~ 2015-02-28 |
Please comment or provide details below to improve the information on AUTUMN SMITH.
| 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).