JESSALYN FORELLA (Credential# 1682692) is licensed (Controlled Substance Registration for Practitioner) with Connecticut Department of Consumer Protection. The license effective date is August 12, 2019. The license expiration date date is February 28, 2021. The license status is ACTIVE.
JESSALYN FORELLA is licensed with the Department of Consumer Protection of Connecticut. The credential number is #CSP.0072226. The credential type is controlled substance registration for practitioner. The effective date is August 12, 2019. The expiration date is February 28, 2021. The business address is 355 Atlantic St Apt 8g, Stamford, CT 06901-3552. The current status is active.
| Licensee Name | JESSALYN FORELLA |
| Credential ID | 1682692 |
| Credential Number | CSP.0072226 |
| Credential Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| Business Address |
355 Atlantic St Apt 8g Stamford CT 06901-3552 |
| Business Type | INDIVIDUAL |
| Status | ACTIVE - CURRENT |
| Active | 1 |
| Issue Date | 2019-08-12 |
| Effective Date | 2019-08-12 |
| Expiration Date | 2021-02-28 |
| Refresh Date | 2019-08-12 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 1668927 | 2.012583 | Dentist | 2019-07-17 | 2020-01-01 - 2020-12-31 | ACTIVE |
| Street Address | 355 ATLANTIC ST APT 8G |
| City | STAMFORD |
| State | CT |
| Zip Code | 06901-3552 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Jisun Lee | 140 Grove St #3a, Stamford, CT 06901 | Combination Nail Technician, Esthetician Or Eyelash Technici | 2020-06-26 ~ 2021-07-31 |
| Sbarro # 968 | 100 Greyrock Place, Stamford, CT 06901 | Bakery | 2020-07-01 ~ 2021-06-30 |
| Sausan A Hilmi Md | Ehe International, Stamford, CT 06901 | Physician/surgeon | 2020-08-01 ~ 2021-07-31 |
| Andrew Sosa | 66 Summer Street Apt 1508, Stamford, CT 06901 | Physician/surgeon | 2020-07-01 ~ 2021-06-30 |
| Melissa Kay Rosenberg | 180 Broad Street, Stamford, CT 06901 | Speech and Language Pathologist | 2020-07-01 ~ 2021-06-30 |
| Niki Maroulakos | 1 Broad Street, Stamford, CT 06901 | Real Estate Salesperson | 2020-06-16 ~ 2021-05-31 |
| Ana D Granda | 355 Atlantic St Unit 20d, Stamford, CT 06901 | Real Estate Salesperson | 2020-06-11 ~ 2021-05-31 |
| Zachary Daly Walzer | 800 Summer St, Stamford, CT 06901 | Notary Public Appointment | 2020-06-16 ~ 2025-06-30 |
| Kathy E Dunigan | 2 Canterbury Green #2508, Stamford, CT 06901 | Notary Public Appointment | 2020-06-16 ~ 2025-06-30 |
| Iwona Grzebyk | 99 Prospect Str Apt 5e, Stamford, CT 06901 | Esthetician | 2020-06-13 ~ 2022-03-31 |
| Find all Licenses in zip 06901 | |||
| City | STAMFORD |
| Zip Code | 06901 |
| License Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| License Type + County | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER + STAMFORD |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Steven Kassels Md · Community Substance Abuse Center | Comm. Physicians PC/125 North Elm Street, Westfield, MA 01085 | Controlled Substance Registration for Practitioner | 2018-06-15 ~ 2019-02-28 |
| Shu-i Lin | CT | Controlled Substance Registration for Practitioner | 2017-06-12 ~ 2019-02-28 |
| Huu Duc D Luu | 630 Mix Ave Apt 6p, Hamden, CT 06514-2320 | Controlled Substance Registration for Practitioner | 2011-03-01 ~ 2013-02-28 |
| Hae J Kim Pa | New Haven, CT 06511 | Controlled Substance Registration for Practitioner | 2008-03-31 ~ 2009-02-28 |
| Arundati Rao | CT | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Erin K Fee | CT | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Min Jin Kim | 639 4th Ave Apt 5c, Brooklyn, NY 11232-1048 | Controlled Substance Registration for Practitioner | 2012-05-10 ~ 2013-02-28 |
| Qi Che Md | Bridgeport, CT 06610 | Controlled Substance Registration for Practitioner | 2006-03-01 ~ 2007-02-28 |
| Yat Tse Md | 174 Hillspoint Rd, Westport, CT 06880 | Controlled Substance Registration for Practitioner | 1994-11-02 ~ 1996-11-01 |
| Kim Whitesell Md | 22 Elm St, New Haven, CT 06511 | Controlled Substance Registration for Practitioner | 1995-01-26 ~ 1996-02-28 |
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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).