ELEANOR A BERRY MD (Credential# 193213) is licensed (Controlled Substance Registration for Practitioner) with Connecticut Department of Consumer Protection. The license effective date is March 1, 2019. The license expiration date date is February 28, 2021. The license status is ACTIVE.
ELEANOR A BERRY MD is licensed with the Department of Consumer Protection of Connecticut. The credential number is #CSP.0026868. The credential type is controlled substance registration for practitioner. The effective date is March 1, 2019. The expiration date is February 28, 2021. The business address is 134 Grandview Ave Suite #210, Waterbury, CT 06708. The current status is active.
| Licensee Name | ELEANOR A BERRY MD |
| Business Name | C/O ROBERT SAMUELSON |
| Credential ID | 193213 |
| Credential Number | CSP.0026868 |
| Credential Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| Business Address |
134 Grandview Ave Suite #210 Waterbury CT 06708 |
| Business Type | INDIVIDUAL |
| Status | ACTIVE - CURRENT |
| Active | 1 |
| Issue Date | 1999-03-01 |
| Effective Date | 2019-03-01 |
| Expiration Date | 2021-02-28 |
| Refresh Date | 2019-02-15 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 554377 | 1.036786 | Physician/Surgeon | 1998-04-17 | 2019-08-01 - 2020-07-31 | ACTIVE |
| Street Address | 134 GRANDVIEW AVE SUITE #210 |
| City | WATERBURY |
| State | CT |
| Zip Code | 06708 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Lee Ann M Soden · Schmacher | 925 Oronoke Rd, Waterbury, CT 06708 | Registered Nurse | 2020-09-01 ~ 2021-08-31 |
| Sega Ready Mix | 310 Chase River Rd, Waterbury, CT 06708 | Operator of Weighing & Measuring Devices | 2020-08-01 ~ 2021-07-31 |
| Mary F Chinn | 24 Taft Pointe Unit 47, Waterbury, CT 06708 | Notary Public Appointment | 2005-09-01 ~ 2010-08-31 |
| Joseph Silva | 65 Dixie Ave., Waterbury, CT 06708 | Medication Administration Certification | 2020-06-03 ~ 2022-06-02 |
| Mandy M Desjarlais | 171 Herschel Ave, Waterbury, CT 06708 | Licensed Practical Nurse | 2020-07-01 ~ 2021-06-30 |
| Francisco J Colon Rodriguez LLC | 55 Eastern Ave Apt42, Waterbury, CT 06708 | Home Improvement Contractor | 2020-06-24 ~ 2020-11-30 |
| Morgan Sunyoung Heo | 1249 West Main Street, Waterbury, CT 06708 | Combination Nail Technician, Esthetician Or Eyelash Technici | ~ |
| Peter Mmangisa Chonga | 119 Taft Pt, Waterbury, CT 06708 | Registered Nurse | 2020-07-01 ~ 2021-06-30 |
| Xuemei Li | 28 Cronin Dr, Waterbury, CT 06708 | Combination Nail Technician, Esthetician Or Eyelash Technici | ~ |
| Tasheaka R Jones | 151 Park Terr, Waterbury, CT 06708 | Registered Nurse | 2020-07-01 ~ 2021-06-30 |
| Find all Licenses in zip 06708 | |||
| City | WATERBURY |
| Zip Code | 06708 |
| License Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| License Type + County | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER + WATERBURY |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Robert W Berry Md · Saint Vincents Medical Center | 2800 Main Street, Bridgeport, CT 06606 | Controlled Substance Registration for Practitioner | 1994-06-09 ~ 1996-07-01 |
| Brooke J Samuelson Aprn | 90 Joshua Trail, Madison, CT 06443 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Ryan M Colligan | 34 Berry St Apt 6g, Brooklyn, NY 11249-1041 | Controlled Substance Registration for Practitioner | 2019-06-03 ~ 2021-02-28 |
| Cecile Berry | 98 Charolais Way, Burlington, CT 06013 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| James R Berry | 211 Banks Rd, Easton, CT 06612-1627 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Eleanor C Doig | 166 Main St, Concord, MA 01742-2445 | Controlled Substance Registration for Practitioner | 2013-01-02 ~ 2015-02-28 |
| Eleanor A Pringle | 122 Killingworth Rd, Higganum, CT 06441 | Controlled Substance Registration for Practitioner | 2013-03-01 ~ 2015-02-28 |
| Eleanor A Knopp | 12 Academy St Apt 3b, New Haven, CT 06511-6973 | Controlled Substance Registration for Practitioner | 2011-03-01 ~ 2013-02-28 |
| Hollister L Berry Aprn | 55 Lock St, New Haven, CT 06511 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Bethany R Berry Lnm | 22 Yelping Hill Rd, Cornwall, CT 06796 | Controlled Substance Registration for Practitioner | 2011-03-21 ~ 2013-02-28 |
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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).