JI MOON SUR (Credential# 1691858) is licensed (Controlled Substance Registration for Practitioner) with Connecticut Department of Consumer Protection. The license effective date is September 16, 2019. The license expiration date date is February 28, 2021. The license status is ACTIVE.
JI MOON SUR is licensed with the Department of Consumer Protection of Connecticut. The credential number is #CSP.0072429. The credential type is controlled substance registration for practitioner. The effective date is September 16, 2019. The expiration date is February 28, 2021. The business address is 10212 Town Walk Dr, Hamden, CT 06518-3720. The current status is active.
| Licensee Name | JI MOON SUR |
| Credential ID | 1691858 |
| Credential Number | CSP.0072429 |
| Credential Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| Business Address |
10212 Town Walk Dr Hamden CT 06518-3720 |
| Business Type | INDIVIDUAL |
| Status | ACTIVE - CURRENT |
| Active | 1 |
| Issue Date | 2019-09-16 |
| Effective Date | 2019-09-16 |
| Expiration Date | 2021-02-28 |
| Refresh Date | 2020-04-27 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 1650644 | 2.012625 | Dentist | 2019-09-03 | 2019-09-03 - 2020-09-30 | ACTIVE |
| Street Address | 10212 TOWN WALK DR |
| City | HAMDEN |
| State | CT |
| Zip Code | 06518-3720 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Michael J Brask | 10202 Town Walk Dr, Hamden, CT 06518-3720 | Controlled Substance Registration for Practitioner | 2017-03-01 ~ 2019-02-28 |
| Philip J Brazalovich | 10223 Town Walk Dr, Hamden, CT 06518-3720 | Athletic Trainer | 2017-02-01 ~ 2018-01-31 |
| Rogerio M Ramos Md | 10221 Town Walk Dr., Hamden, CT 06518-3720 | Controlled Substance Registration for Practitioner | 2009-03-01 ~ 2011-02-28 |
| Nelson T Camp | 10213 Town Walk Dr, Hamden, CT 06518-3720 | Emergency Medical Technician | 2010-02-23 ~ 2012-10-01 |
| Kason Wan | 10202 Town Walk Dr, Hamden, CT 06518-3720 | Emergency Medical Technician | 2012-12-19 ~ 2015-10-01 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Barbara Esposito Aprn | 209 Todd St, Hamden, CT 06518 | Advanced Practice Registered Nurse | 2020-08-01 ~ 2021-07-31 |
| Sorrentos Brick Oven Pizzeria | 244 Skiff St, Hamden, CT 06518 | Bakery | 2020-07-01 ~ 2021-06-30 |
| Jenna Bump | 61 Cannon St, Hamden, CT 06518 | Registered Nurse | 2020-07-01 ~ 2021-06-30 |
| Jennifer E Pohl | 70 Norwood Avenue, Hamden, CT 06518 | Speech and Language Pathologist | 2020-07-01 ~ 2021-06-30 |
| Nicole O Miller-tyson | 648 Evergreen Ave, Hamden, CT 06518 | Registered Nurse | 2020-09-01 ~ 2021-08-31 |
| Nancy D Anderson | 399 Hillfield Road, Hamden, CT 06518 | Speech and Language Pathologist | 2020-08-01 ~ 2021-07-31 |
| Flowers From The Farm | 1035 Shepard Avenue, Hamden, CT 06518 | Operator of Weighing & Measuring Devices | 2020-08-01 ~ 2021-07-31 |
| Lynda Burke | 68 Linden Avenue, Hamden, CT 06518 | Notary Public Appointment | 2011-12-08 ~ 2016-12-31 |
| Kelly Lynn Huppert | 1334 Town Walk Dr, Hamden, CT 06518 | Master's Level Social Worker | ~ |
| Robert L Engengro | 365 Forest Street, Hamden, CT 06518 | Real Estate Salesperson | 2020-06-23 ~ 2021-05-31 |
| Find all Licenses in zip 06518 | |||
| City | HAMDEN |
| Zip Code | 06518 |
| License Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| License Type + County | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER + HAMDEN |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Jungsoo Moon | 100 Parrott Dr., Shelton, CT 06484 | Controlled Substance Registration for Practitioner | 2013-03-01 ~ 2015-02-28 |
| Susana Moon Cho | 416 57th St Apt 3, Brooklyn, NY 11220-3407 | Controlled Substance Registration for Practitioner | 2011-03-03 ~ 2013-02-28 |
| Ashley S Moon | 126 Waverly Palce Apt 3d, New York, NY 10011 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Genevieve N Dinh | 2640 Moon Chase Ln, Buford, GA 30519-5363 | Controlled Substance Registration for Practitioner | 2017-03-01 ~ 2019-02-28 |
| Dong Y Moon | 247 Smith Ridge Rd, South Salem, NY 10590-2210 | Controlled Substance Registration for Practitioner | 2015-03-01 ~ 2017-02-28 |
| Burton M Cunin | 6010 N. Desert Moon Ct, Tucson, AZ 85750 | Controlled Substance Registration for Practitioner | 2013-03-01 ~ 2015-02-28 |
| Won K Moon Md | 2631 Mohawk Circle, West Palm Beach, FL 33409 | Controlled Substance Registration for Practitioner | 2011-03-01 ~ 2013-02-28 |
| Marianne Moon | 40 Prospect Avenue Building 2 Apartment 4h, Norwalk, CT 06850 | Controlled Substance Registration for Practitioner | 2009-03-01 ~ 2011-02-28 |
| Suzanne Keenan Aprn | 475 Winged Foot Rd, Half Moon Bay, CA 94019-2232 | Controlled Substance Registration for Practitioner | 2009-03-01 ~ 2011-02-28 |
| 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 |
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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).