DENISE MATTOX MD (Credential# 177954) is licensed (Controlled Substance Registration for Practitioner) with Connecticut Department of Consumer Protection. The license effective date is August 12, 1996. The license expiration date date is February 28, 1998. The license status is INACTIVE.
DENISE MATTOX MD is licensed with the Department of Consumer Protection of Connecticut. The credential number is #CSP.0024579. The credential type is controlled substance registration for practitioner. The effective date is August 12, 1996. The expiration date is February 28, 1998. The business address is 320 Pomfret St, Putnam, CT 06260. The current status is inactive.
Licensee Name | DENISE MATTOX MD |
Credential ID | 177954 |
Credential Number | CSP.0024579 |
Credential Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
Business Address |
320 Pomfret St Putnam CT 06260 |
Business Type | INDIVIDUAL |
Status | INACTIVE |
Effective Date | 1996-08-12 |
Expiration Date | 1998-02-28 |
Refresh Date | 2004-04-23 |
ID | Credential Code | Credential Type | Issue | Term | Status |
---|---|---|---|---|---|
548534 | 1.030561 | Physician/Surgeon | 1990-02-02 | 1992-10-23 - 1996-09-30 | INACTIVE |
Street Address | 320 POMFRET ST |
City | PUTNAM |
State | CT |
Zip Code | 06260 |
Licensee Name | Office Address | Credential | Effective / Expiration |
---|---|---|---|
Day Kimball Hospital | 320 Pomfret St, Putnam, CT 06260-1836 | General Hospital | 2019-10-01 ~ 2021-09-30 |
Gino C Bottino | 320 Pomfret St, Putnam, CT 06260-1836 | Physician/surgeon | 2020-07-01 ~ 2021-06-30 |
Marc B Cerrone | 320 Pomfret St, Putnam, CT 06260 | Physician/surgeon | 2020-04-01 ~ 2021-03-31 |
Anthony Chieffalo | 320 Pomfret St, Putnam, CT 06260-1836 | Physician/surgeon | 2020-04-01 ~ 2021-03-31 |
Ana Mafalda Andrade Tudela Martins | 320 Pomfret St, Putnam, CT 06260-1836 | Physician/surgeon | 2020-04-01 ~ 2021-03-31 |
Amna Aziz | 320 Pomfret St, Putnam, CT 06260-1836 | Physician/surgeon | 2020-04-01 ~ 2021-03-31 |
Ronald J Franzino Md | 320 Pomfret St, Putnam, CT 06260 | Physician/surgeon | 2020-04-01 ~ 2021-03-31 |
Day Kimball Hospital | 320 Pomfret St, Putnam, CT 06260-1836 | Controlled Substance Registration for Hospitals | 2019-03-01 ~ 2021-02-28 |
Susan Brazille | 320 Pomfret St, Putnam, CT 06260-1836 | Controlled Substance Registration for Practitioner | 2019-12-09 ~ 2021-02-28 |
James S Peng | 320 Pomfret St, Putnam, CT 06260-1836 | Controlled Substance Registration for Practitioner | 2019-09-03 ~ 2021-02-28 |
Find all Licenses in the same address |
Licensee Name | Office Address | Credential | Effective / Expiration |
---|---|---|---|
Amanda L Neal | 69 Hawkins Road, Putnam, CT 06260 | Professional Counselor | 2020-08-01 ~ 2021-07-31 |
Kellys Tire Inc | 306 School St, Putnam, CT 06260 | Operator of Weighing & Measuring Devices | 2020-08-01 ~ 2021-07-31 |
Donna Dumas | 19 Arthur Street, Putnam, CT 06260 | Medication Administration Certification | 2020-07-16 ~ 2022-07-15 |
Mcdonalds #13538 | 6 Rpovidence Pike, Putnam, CT 06260 | Frozen Dessert Retailer | 2020-06-22 ~ 2020-12-31 |
Cynthia C Paquin | 95 Elvira Heights Road, Putnam, CT 06260 | Dental Hygienist | 2018-11-01 ~ 2019-10-31 |
Scott J Grimmett · Price Chopper | 251 Kennedy Drive Ste A, Putnam, CT 06260 | Grocery Beer | 2020-08-08 ~ 2021-08-07 |
Lyne A Grillo · Fauteux | 73-155 Perry St, Putnam, CT 06260 | Radiographer | 2020-09-01 ~ 2021-08-31 |
Crossings Restaurant and Brew Pub (the) | 45-47 Main St, Putnam, CT 06260 | Manufacturer for Beer and Brew Pub | 2019-11-26 ~ 2021-03-25 |
June Elizabeth Foley | 4 Libertyhighway, Putnam, CT 06260 | Licensed Clinical Social Worker | 2020-07-01 ~ 2021-06-30 |
Kevin J Bates · K J B Bldg Works | 7 Rowe St, Putnam, CT 06260 | Home Improvement Contractor | 2020-06-12 ~ 2020-11-30 |
Find all Licenses in zip 06260 |
City | PUTNAM |
Zip Code | 06260 |
License Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
License Type + County | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER + PUTNAM |
Licensee Name | Office Address | Credential | Effective / Expiration |
---|---|---|---|
Denise E Pratt | 62 North St, Litchfield, CT 06759 | Controlled Substance Registration for Practitioner | 2017-03-01 ~ 2019-02-28 |
Denise L Morrison | 159 Union St. Apt B-6, Bristol, CT 06010 | Controlled Substance Registration for Practitioner | 2015-03-01 ~ 2017-02-28 |
Denise C Macchiarolo | 56 Idlewood Rd, Wolcott, CT 06716 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
Denise S Duplessis | 3 Pomfret Way, Greene, RI 02827-1632 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
Denise M French | 355 Alden Ave Apt B, New Haven, CT 06515 | Controlled Substance Registration for Practitioner | 2005-03-01 ~ 2006-02-28 |
Denise Pumphrey | 7 1/2 Frederick St, Westfield, MA 01085-3105 | Controlled Substance Registration for Practitioner | 2013-03-01 ~ 2015-02-28 |
Denise Mccormack | 24 Hospital Ave, Danbury, CT 06810-6099 | Controlled Substance Registration for Practitioner | 2011-03-01 ~ 2013-02-28 |
Denise Ripley Pa | 2 Winslow Dr, Exeter, NH 03833 | Controlled Substance Registration for Practitioner | 2013-02-05 ~ 2013-02-28 |
Denise L Wilbert Pa-c | 204 Grove St, Hanover, MA 02339 | Controlled Substance Registration for Practitioner | 2017-03-01 ~ 2019-02-28 |
Denise De Los Santos | 24 Hospital Ave, Danbury, CT 06810-6099 | Controlled Substance Registration for Practitioner | 2013-07-09 ~ 2015-02-28 |
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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).