OLIVIA MICHELLE MULLA (Credential# 2059000) is licensed (Controlled Substance Registration for Practitioner) with Connecticut Department of Consumer Protection. The license effective date is June 24, 2020. The license expiration date date is February 28, 2021. The license status is APPROVED.
OLIVIA MICHELLE MULLA is licensed with the Department of Consumer Protection of Connecticut. The credential number is #CSP.0074678. The credential type is controlled substance registration for practitioner. The effective date is June 24, 2020. The expiration date is February 28, 2021. The business address is 3270 Creekside Cir, Walworth, NY 14568-9463. The current status is approved.
| Licensee Name | OLIVIA MICHELLE MULLA |
| Credential ID | 2059000 |
| Credential Number | CSP.0074678 |
| Credential Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| Business Address |
3270 Creekside Cir Walworth NY 14568-9463 |
| Business Type | INDIVIDUAL |
| Status | APPROVED - CURRENT |
| Active | 1 |
| Issue Date | 2020-06-24 |
| Effective Date | 2020-06-24 |
| Expiration Date | 2021-02-28 |
| Refresh Date | 2020-06-24 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 2034915 | 23.004833 | Physician Assistant | 2020-06-20 | 2020-06-20 - 2020-12-31 | ACTIVE |
| Street Address | 3270 CREEKSIDE CIR |
| City | WALWORTH |
| State | NY |
| Zip Code | 14568-9463 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Todd M Liebert | 1620 Eddy Rd, Walworth, NY 14568 | Architect | 2019-08-01 ~ 2020-07-31 |
| Delaney Joan Seaman | 3192 Valley Drive, Walworth, NY 14568 | Registered Nurse | 2018-02-14 ~ 2018-12-31 |
| Gary R Yenei | 5031 Arbor Rd., Walworth, NY 14568 | Asbestos Abatement Supervisor | 2000-11-20 ~ 2001-08-31 |
| Robbie R Williamson | 3245 Woodfield Dr, Walworth, NY 14568-9443 | Athletic Trainer | 2018-04-01 ~ 2019-03-31 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Susan E Rowland | N850 Ridge Road, Walworth, WI 53184 | Pharmacist | 2001-02-01 ~ 2002-01-31 |
| Putnam Company Inc | Po Box 310, Walworth, WI 53184 | Manufacturer of Bedding & Upholstered Furniture | 1998-05-01 ~ 1999-04-30 |
| City | WALWORTH |
| Zip Code | 14568 |
| License Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| License Type + County | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER + WALWORTH |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Michelle Olivia Dao | 326 Washington St., Norwich, CT 06360 | Controlled Substance Registration for Practitioner | 2017-05-23 ~ 2019-02-28 |
| Adil D Mulla | 24 Hospital Ave, Danbury, CT 06810-6099 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Tehmi D Mulla Md | 23 Fresh Meadow Road, Monroe, CT 06468 | Controlled Substance Registration for Practitioner | 2013-03-01 ~ 2015-02-28 |
| Olivia R Enright | 42 Ridge Street, Cos Cob, CT 06807 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Olivia D Carter | 213 Glen St, New Britain, CT 06051-3027 | Controlled Substance Registration for Practitioner | 2019-01-07 ~ 2021-02-28 |
| Olivia R Wright Md | 922 Quinnipiac Ave Apt #3, New Haven, CT 06513 | Controlled Substance Registration for Practitioner | 1999-03-26 ~ 2000-02-28 |
| Olivia J Stumpf | 134 Popes Island Rd, Milford, CT 06461-1738 | Controlled Substance Registration for Practitioner | 2017-03-01 ~ 2019-02-28 |
| Olivia J Koukoularis | 4 Cavasin Dr, East Lyme, CT 06333-1307 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Chloe Olivia Zimmerman | 20 York St Rm 226, New Haven, CT 06510-3220 | Controlled Substance Registration for Practitioner | 2019-06-05 ~ 2021-02-28 |
| Olivia J Carpinello IIi | 101 N Main St, West Hartford, CT 06107-1925 | Controlled Substance Registration for Practitioner | 2017-03-01 ~ 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).