LAURA N PETROVICH (Credential# 1805381) is licensed (Controlled Substance Registration for Practitioner) with Connecticut Department of Consumer Protection. The license effective date is November 8, 2019. The license expiration date date is February 28, 2021. The license status is ACTIVE.
LAURA N PETROVICH is licensed with the Department of Consumer Protection of Connecticut. The credential number is #CSP.0072749. The credential type is controlled substance registration for practitioner. The effective date is November 8, 2019. The expiration date is February 28, 2021. The business address is 1224 10th Street, Coronado, CA 92118. The current status is active.
| Licensee Name | LAURA N PETROVICH |
| Credential ID | 1805381 |
| Credential Number | CSP.0072749 |
| Credential Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| Business Address |
1224 10th Street Coronado CA 92118 |
| Business Type | INDIVIDUAL |
| Status | ACTIVE - CURRENT |
| Active | 1 |
| Issue Date | 2019-11-08 |
| Effective Date | 2019-11-08 |
| Expiration Date | 2021-02-28 |
| Refresh Date | 2019-11-14 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 1490125 | 1.060179 | Physician/Surgeon | 2018-03-22 | 2020-01-01 - 2020-12-31 | ACTIVE |
| Street Address | 1224 10th Street |
| City | Coronado |
| State | CA |
| Zip Code | 92118 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Roozbeh Badii | 449 B Ave, Coronado, CA 92118 | Physician/surgeon | 2019-10-01 ~ 2020-09-30 |
| Joseph P Commette Jr | 249 H. Avenue, Coronado, CA 92118 | Dentist | 1998-02-19 ~ 1999-04-30 |
| Kristine M Ver Weire | 846 A. Avenue, Coronado, CA 92118 | Dental Hygienist | 1996-09-23 ~ 1997-09-30 |
| Margaret Moore | 750 Alameda Blvd, Coronado, CA 92118 | Registered Nurse | 1998-01-09 ~ 1999-03-31 |
| Andrew J Aguilar | 1316 Glorietta Blvd, Coronado, CA 92118 | Engineer-in-training | 1996-11-12 ~ 2006-11-12 |
| Robert A Braun Md | 601 Coronado Ave, Coronado, CA 92118 | Controlled Substance Registration for Practitioner | 2002-08-19 ~ 2003-02-28 |
| Coronado Brewing Company | 170 Orange Ave, Coronado, CA 92118-1409 | Out of State Shipper Beer | 2016-09-20 ~ 2017-09-10 |
| Bryn Joy Hogan | 1213 1st St # 112, Coronado, CA 92118-1414 | Registered Nurse | 2010-06-29 ~ 2010-10-31 |
| Kaitlyn E Albert | 536 B Ave Unit 4, Coronado, CA 92118-1821 | Registered Nurse | 2012-08-01 ~ 2013-07-31 |
| Ryan M Wamhoff | 345 A Ave, Coronado, CA 92118-1973 | Emergency Medical Technician | 2014-08-14 ~ 2017-07-01 |
| Find all Licenses in zip 92118 | |||
| City | Coronado |
| Zip Code | 92118 |
| License Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| License Type + County | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER + Coronado |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Laura J Hodges Md | Laura Hodges Md, Darien, CT 06820 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Laura A Roy | 15 Stonehedge Dr, Tolland, CT 06084 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Laura C Macbeth | 1 Theall Rd, Rye, NY 10580-1404 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Laura Triano Md | Po Box 167, Milldale, CT 06467 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Laura Gilroy | Stamford, CT 06904 | Controlled Substance Registration for Practitioner | ~ |
| Laura A Schmidt | 61 Olive St, Northampton, MA 01060-4215 | Controlled Substance Registration for Practitioner | 2012-02-24 ~ 2013-02-28 |
| Laura Bujold | 3 Benjamin Rd, Ellington, CT 06029 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| John A Kiselak Md | 30 Laura Dr, Danbury, CT 06811 | Controlled Substance Registration for Practitioner | 1994-04-28 ~ 1995-12-01 |
| Laura Z Quimby Md | Po Box 203844, New Haven, CT 06520 | Controlled Substance Registration for Practitioner | 2005-03-01 ~ 2006-02-28 |
| Laura J Solon Md | 32 Rosemary Ln, S Windsor, CT 06074 | Controlled Substance Registration for Practitioner | 1993-01-07 ~ 1995-02-01 |
Please comment or provide details below to improve the information on LAURA N PETROVICH.
| 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).