SUSAN BRAZILLE (Credential# 1990213) is licensed (Controlled Substance Registration for Practitioner) with Connecticut Department of Consumer Protection. The license effective date is December 9, 2019. The license expiration date date is February 28, 2021. The license status is ACTIVE.
SUSAN BRAZILLE is licensed with the Department of Consumer Protection of Connecticut. The credential number is #CSP.0072881. The credential type is controlled substance registration for practitioner. The effective date is December 9, 2019. The expiration date is February 28, 2021. The business address is 320 Pomfret St, Putnam, CT 06260-1836. The current status is active.
| Licensee Name | SUSAN BRAZILLE |
| Credential ID | 1990213 |
| Credential Number | CSP.0072881 |
| Credential Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| Business Address |
320 Pomfret St Putnam CT 06260-1836 |
| Business Type | INDIVIDUAL |
| Status | ACTIVE - CURRENT |
| Active | 1 |
| Issue Date | 2019-12-09 |
| Effective Date | 2019-12-09 |
| Expiration Date | 2021-02-28 |
| Refresh Date | 2019-12-11 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 1805191 | 1.064650 | Physician/Surgeon | 2019-12-06 | 2019-12-06 - 2020-09-30 | ACTIVE |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Susan Brazille | 80 Seymour St, Po Box 5037, Hartford, CT 06102-5037 | Resident Physician | 2019-06-17 ~ 2019-07-14 |
| Street Address | 320 POMFRET ST |
| City | PUTNAM |
| State | CT |
| Zip Code | 06260-1836 |
| 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 |
| James S Peng | 320 Pomfret St, Putnam, CT 06260-1836 | Controlled Substance Registration for Practitioner | 2019-09-03 ~ 2021-02-28 |
| Ernesto Sire Diaz | 320 Pomfret St, Putnam, CT 06260-1836 | Controlled Substance Registration for Practitioner | 2019-08-23 ~ 2021-02-28 |
| Find all Licenses in the same address | |||
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Juan M Perez Velazquez | Day Kimball Hospital, Putnam, CT 06260-1836 | Physician/surgeon | 2018-07-01 ~ 2019-06-30 |
| Sagar Verma | 320 Pomfret Street, Putnam, CT 06260-1836 | Controlled Substance Registration for Practitioner | 2013-03-01 ~ 2015-02-28 |
| 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 |
|---|---|---|---|
| Susan B Kohn | 232 Second Rd, Summertown, TN 38483-8019 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Susan J Lee | 111 Park St Apt 14e, New Haven, CT 06511 | Controlled Substance Registration for Practitioner | 2004-09-14 ~ 2005-02-28 |
| Susan Park Md | 1 Theall Rd, Rye, NY 10580 | Controlled Substance Registration for Practitioner | 2009-03-01 ~ 2011-02-28 |
| Susan P May | 40 Tunxis Vlg, Farmington, CT 06032-1518 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Susan Mucha | 119 Halstead Ave Apt 2, Greenwich, CT 06831 | Controlled Substance Registration for Practitioner | 2009-03-01 ~ 2011-02-28 |
| Susan Floyd Vmd | 26 Noroton Ave, Darien, CT 06820 | Controlled Substance Registration for Practitioner | 2001-04-04 ~ 2002-02-28 |
| Susan B Cleary Dvm | 16 Tracy Cir, Amherst, MA 01002-3235 | Controlled Substance Registration for Practitioner | 2013-03-01 ~ 2015-02-28 |
| Susan A Kline | 561 Pequot Ave, Southport, CT 06890-1366 | Controlled Substance Registration for Practitioner | 2013-03-01 ~ 2015-02-28 |
| Susan R Lieb | 100 Avonridge, Avon, CT 06001-4039 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Susan E Campbell | 80 Perkins St, Springfield, MA 01118-2044 | Controlled Substance Registration for Practitioner | 2019-10-10 ~ 2021-02-28 |
Please comment or provide details below to improve the information on SUSAN BRAZILLE.
| 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).