EARLENE PECKHAM APRN (Credential# 210775) 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.
EARLENE PECKHAM APRN is licensed with the Department of Consumer Protection of Connecticut. The credential number is #CSP.0028087. 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 658 Chestnut Ridge Rd, Orange, CT 06477-2029. The current status is active.
| Licensee Name | EARLENE PECKHAM APRN |
| Credential ID | 210775 |
| Credential Number | CSP.0028087 |
| Credential Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| Business Address |
658 Chestnut Ridge Rd Orange CT 06477-2029 |
| Business Type | INDIVIDUAL |
| Status | ACTIVE - CURRENT |
| Active | 1 |
| Issue Date | 1999-06-18 |
| Effective Date | 2019-03-01 |
| Expiration Date | 2021-02-28 |
| Refresh Date | 2019-01-02 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 634713 | 10.R22972 | Registered Nurse | 1971-03-15 | 2020-02-01 - 2021-01-31 | ACTIVE |
| 678610 | 12.000425 | Advanced Practice Registered Nurse | 1991-07-09 | 2020-02-01 - 2021-01-31 | ACTIVE |
| Street Address | 658 CHESTNUT RIDGE RD |
| City | ORANGE |
| State | CT |
| Zip Code | 06477-2029 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Cora E Stover | 650 Chestnut Ridge Rd, Orange, CT 06477-2029 | Naturopathic Physician | 2020-06-01 ~ 2021-05-31 |
| Constantine F Michaelides | 616 Chestnut Ridge Rd, Orange, CT 06477-2029 | Controlled Substance Registration for Practitioner | 2008-09-18 ~ 2009-02-28 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Rakesh H Patel Md | 596 Cedar Grove, Orange, CT 06477 | Physician/surgeon | 2020-07-01 ~ 2021-06-30 |
| John D Mainwaring Dds | 240 Indian River Rd, Suite A7, Orange, CT 06477 | Dentist | 2020-08-01 ~ 2021-07-31 |
| Hea Sun Kwak | 477 Howellton Rd, Orange, CT 06477 | Combination Nail Technician, Esthetician Or Eyelash Technici | 2020-06-26 ~ 2021-08-31 |
| Munsons Candy Kitchen Inc | 109 Boston Post Rd, Orange, CT 06477 | Operator of Weighing & Measuring Devices | 2020-08-01 ~ 2021-07-31 |
| Takashi Yoshikawa | 151 Old Tavern Road, Orange, CT 06477 | Hairdresser/cosmetician | 2020-09-01 ~ 2022-08-31 |
| Yam Wong | 21 Country Club Close, Orange, CT 06477 | Notary Public Appointment | 2020-06-26 ~ 2025-06-30 |
| Shitong Liu | 519 Boston Post Rd Orange, Orange, CT 06477 | Nail Technician | ~ |
| Robert A Lamparski | Po B0x# 1183, Orange, CT 06477 | Real Estate Salesperson | 2019-06-01 ~ 2020-05-31 |
| Rolando R Lopez | 22 Tyler City Rd, Orange, CT 06477 | Physician Assistant | 2020-07-01 ~ 2021-06-30 |
| Lisa Courtney | 470 Locust Drive, Orange, CT 06477 | Notary Public Appointment | 2020-09-01 ~ 2025-08-31 |
| Find all Licenses in zip 06477 | |||
| City | ORANGE |
| Zip Code | 06477 |
| License Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| License Type + County | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER + ORANGE |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Samuel E Peckham | 100 Tater Hill Rd, East Haddam, CT 06423-1601 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Jane F Moysak Aprn | 68 Rye Rd, Rye, NY 10580-2228 | Controlled Substance Registration for Practitioner | 2009-03-01 ~ 2011-02-28 |
| Ann Burzynski Aprn | Po Box 158, Colchester, VT 05446-0158 | Controlled Substance Registration for Practitioner | 2009-03-01 ~ 2011-02-28 |
| Michael P Riordan Aprn | Niantic, CT 06357 | Controlled Substance Registration for Practitioner | 2007-03-01 ~ 2008-02-29 |
| Jennifer L Yau Aprn | 627 Chapel St Apt 3a, New Haven, CT 06511-6994 | Controlled Substance Registration for Practitioner | 2011-03-01 ~ 2013-02-28 |
| Evelyne Y Lo Aprn | 39 Bontempo Rd, Newton, MA 02459-3601 | Controlled Substance Registration for Practitioner | 2017-03-01 ~ 2019-02-28 |
| Catherine Elliott Aprn | Po Box 577, Freedom, NH 03836 | Controlled Substance Registration for Practitioner | 2006-03-01 ~ 2007-02-28 |
| Jessica L Rak Aprn | 700 Summer St, Stamford, CT 06901 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Evelyn J Lai Aprn | 83 Nicoll St, New Haven, CT 06511-2621 | Controlled Substance Registration for Practitioner | 2011-09-02 ~ 2013-02-28 |
| Leana F Yee Aprn | 561 Baldwin Ave, Meriden, CT 06450 | Controlled Substance Registration for Practitioner | 2006-03-01 ~ 2007-02-28 |
Please comment or provide details below to improve the information on EARLENE PECKHAM APRN.
| 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).