JEREMY ROGER MACK (Credential# 1675990) is licensed (Controlled Substance Registration for Practitioner) with Connecticut Department of Consumer Protection. The license effective date is July 16, 2019. The license expiration date date is February 28, 2021. The license status is ACTIVE.
JEREMY ROGER MACK is licensed with the Department of Consumer Protection of Connecticut. The credential number is #CSP.0071949. The credential type is controlled substance registration for practitioner. The effective date is July 16, 2019. The expiration date is February 28, 2021. The business address is 19 E 88th St Apt 1d, New York, NY 10128-0558. The current status is active.
| Licensee Name | JEREMY ROGER MACK |
| Credential ID | 1675990 |
| Credential Number | CSP.0071949 |
| Credential Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| Business Address |
19 E 88th St Apt 1d New York NY 10128-0558 |
| Business Type | INDIVIDUAL |
| Status | ACTIVE - CURRENT |
| Active | 1 |
| Issue Date | 2019-07-16 |
| Effective Date | 2019-07-16 |
| Expiration Date | 2021-02-28 |
| Refresh Date | 2019-07-17 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 1613542 | 1.063970 | Physician/Surgeon | 2019-07-16 | 2019-07-16 - 2020-03-31 | ACTIVE |
| Street Address | 19 E 88TH ST APT 1D |
| City | NEW YORK |
| State | NY |
| Zip Code | 10128-0558 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Kevin D Plancher Md | 1160 Park Avenue, New York, NY 10128 | Physician/surgeon | 2020-07-01 ~ 2021-06-30 |
| David Vlahov | 250 E 87th St. Apt 25aj, New York, NY 10128 | Registered Nurse | 2020-09-01 ~ 2021-08-31 |
| Richard Lewis Kadin | 47 E. 87th Street, New York, NY 10128 | Architect | 2018-08-01 ~ 2019-07-31 |
| Wesbuilt Construction Managers LLC | 145 E 94th Street, New York, NY 10128 | Major Contractor | 2018-07-01 ~ 2019-06-30 |
| Gain G Lu | 110 East 87th Street, 3e, New York, NY 10128 | Dentist | 2020-04-01 ~ 2021-03-31 |
| Mitzi H Liotta | 45 East 89th St, New York, NY 10128 | Licensed Clinical Social Worker | 2020-05-01 ~ 2021-04-30 |
| Carla Gergi Sawan | Apartment 5g, New York, NY 10128 | Physician/surgeon | ~ |
| Tyler S Lucas Md | 1349 Lexington Avenue #4d, New York, NY 10128 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Peter S Rattner | 50 East 89th St, New York, NY 10128 | Physician/surgeon | 2020-07-01 ~ 2021-06-30 |
| Jennifer Sarah Millman | 108 E 96th St, New York, NY 10128 | Physician/surgeon | 2020-06-01 ~ 2021-05-31 |
| Find all Licenses in zip 10128 | |||
| City | NEW YORK |
| Zip Code | 10128 |
| License Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| License Type + County | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER + NEW YORK |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Alphonso L Mack | 30, Burlington, CT 06103 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Michael J Mack | 40 E Putnam Avenue, Cos Cob, CT 06807 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Sarah Daigle | 72 Mack St., Windsor, CT 06095 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Steven C Fitch | 321 Mack Rd, Lebanon, CT 06249-1718 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| John E Kelleher Jr | 26 Mack Rd, Middlefield, CT 06455-1104 | Controlled Substance Registration for Practitioner | 2015-03-01 ~ 2017-02-28 |
| Lisa Mack | 85 Seymour St, Hartford, CT 06106-5501 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| James G Pattillo IIi | 74 Mack St, Windsor, CT 06095 | Controlled Substance Registration for Practitioner | 1999-03-01 ~ 2000-02-28 |
| Philip W Mack Md | 6 Ericka Cir, East Longmeadow, MA 01028-1658 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Shahena Master Do | 74 Mack Street, Windsor, CT 06095 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Christina N Mack | 850 Grand Ave Unit 204, New Haven, CT 06511-4974 | Controlled Substance Registration for Practitioner | 2013-03-06 ~ 2015-02-28 |
Please comment or provide details below to improve the information on JEREMY ROGER MACK.
| 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).