THERESA INTEGRAL DY DJAMA (Credential# 1673942) is licensed (Controlled Substance Registration for Practitioner) with Connecticut Department of Consumer Protection. The license effective date is July 5, 2019. The license expiration date date is February 28, 2021. The license status is ACTIVE.
THERESA INTEGRAL DY DJAMA is licensed with the Department of Consumer Protection of Connecticut. The credential number is #CSP.0071831. The credential type is controlled substance registration for practitioner. The effective date is July 5, 2019. The expiration date is February 28, 2021. The business address is 64 Black Rock Ave, Bridgeport, CT 06605-1649. The current status is active.
| Licensee Name | THERESA INTEGRAL DY DJAMA |
| Credential ID | 1673942 |
| Credential Number | CSP.0071831 |
| Credential Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| Business Address |
64 Black Rock Ave Bridgeport CT 06605-1649 |
| Business Type | INDIVIDUAL |
| Status | ACTIVE - CURRENT |
| Active | 1 |
| Issue Date | 2019-07-05 |
| Effective Date | 2019-07-05 |
| Expiration Date | 2021-02-28 |
| Refresh Date | 2019-07-09 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 1658886 | 19.001043 | Podiatrist | 2019-07-01 | 2019-09-01 - 2020-08-31 | ACTIVE |
| Street Address | 64 Black Rock Ave |
| City | BRIDGEPORT |
| State | CT |
| Zip Code | 06605-1649 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Emely E. Gonzalez | 64 Black Rock Ave, Bridgeport, CT 06605-1200 | Community Health Worker | 2020-03-19 ~ 2023-03-31 |
| Park City Primary Care Center | 64 Black Rock Ave, Bridgeport, CT 06605-1200 | Psychiatric Outpatient Clinic | 2017-04-01 ~ 2021-03-31 |
| Park City Primary Care Center, Inc. | 64 Black Rock Ave, Bridgeport, CT 06605-1200 | Outpatient Clinic | 2017-04-01 ~ 2021-03-31 |
| Debra L Gerson | 64 Black Rock Ave, Bridgeport, CT 06605-1200 | Physician/surgeon | 2018-03-01 ~ 2019-02-28 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Melissa Medina | 102 Clinton Ave., Bridgeport, CT 06605 | Medication Administration Certification | ~ |
| Maria Etelvina Lema | 20 Orland St, Bridgeport, CT 06605 | Nail Technician | ~ |
| Michelle Maldonado M�ndez | 182 Monroe St, Bridgeport, CT 06605 | Combination Nail Technician, Esthetician Or Eyelash Technici | ~ |
| Latavia Henderson | 178 Lewis Street, Bridgeport, CT 06605 | Medication Administration Certification | 2020-06-08 ~ 2022-06-07 |
| Onedu Nnenna Benson | 285 Laurel Avenue, Bridgeport, CT 06605 | Licensed Practical Nurse | ~ |
| Gregory A Korth | 137 Fayerweather Ter, Bridgeport, CT 06605 | Architect | 2020-08-01 ~ 2021-07-31 |
| Kim Anh Ho | 108 Wood Avenue, Bridgeport, CT 06605 | Combination Nail Technician, Esthetician Or Eyelash Technici | ~ |
| Maria-elena Melchor Mora | 653 Colorado Ave, Bridgeport, CT 06605 | Combination Nail Technician, Esthetician Or Eyelash Technici | ~ |
| Jennifer Nelson | 148 St Stephens Road, Bridgeport, CT 06605 | Esthetician | ~ |
| Santa Fuel Inc | 133 Admiral St, Bridgeport, CT 06605 | Operator of Weighing & Measuring Devices | 2020-08-01 ~ 2021-07-31 |
| Find all Licenses in zip 06605 | |||
| City | BRIDGEPORT |
| Zip Code | 06605 |
| License Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| License Type + County | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER + BRIDGEPORT |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Theresa Huh | 825 E 4th St. #410, Los Angeles, CA 90013 | Controlled Substance Registration for Practitioner | 2017-03-01 ~ 2019-02-28 |
| Theresa M Keddy | 21 Fox Run Rd, Unionville, CT 06085-1059 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Theresa A Molisse Md | 9 Turnberry Rd, Wallingford, CT 06492-2743 | Controlled Substance Registration for Practitioner | 2015-03-01 ~ 2017-02-28 |
| Theresa Capra Pa | 161 Peck Ln, Cheshire, CT 06410-2038 | Controlled Substance Registration for Practitioner | 2009-03-01 ~ 2011-02-28 |
| Theresa Marie Ramponi | 928 Elm, New Haven, CT 06511 | Controlled Substance Registration for Practitioner | 2019-04-03 ~ 2021-02-28 |
| Theresa Piotrowski Md | 318 So Main St, Newtown, CT 06470 | Controlled Substance Registration for Practitioner | 2006-03-01 ~ 2007-02-28 |
| Theresa M Suozzi Md | 21 Temple St Apt 201, Hartford, CT 06103-1311 | Controlled Substance Registration for Practitioner | 2013-03-13 ~ 2015-02-28 |
| Theresa Maldonado | 102 Penn Rd, Scarsdale, NY 10583-7558 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Theresa M Nicoladse Lnm | 10 Lucille St, Fairfield, CT 06432 | Controlled Substance Registration for Practitioner | 2003-03-28 ~ 2004-02-28 |
| Theresa Donnelly | 76 Genesee Ln, Madison, CT 06443-1666 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
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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).