MARY T PRONOVOST MD (Credential# 213472) 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.
MARY T PRONOVOST MD is licensed with the Department of Consumer Protection of Connecticut. The credential number is #CSP.0028326. 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 111 Beach Rd, Fairfield, CT 06824. The current status is active.
| Licensee Name | MARY T PRONOVOST MD |
| Credential ID | 213472 |
| Credential Number | CSP.0028326 |
| Credential Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| Business Address |
111 Beach Rd Fairfield CT 06824 |
| Business Type | INDIVIDUAL |
| Status | ACTIVE - CURRENT |
| Active | 1 |
| Issue Date | 1999-06-09 |
| Effective Date | 2019-03-01 |
| Expiration Date | 2021-02-28 |
| Refresh Date | 2019-01-28 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 555293 | 1.037703 | Physician/Surgeon | 1999-04-23 | 2020-01-01 - 2020-12-31 | ACTIVE |
| Street Address | 111 BEACH RD |
| City | FAIRFIELD |
| State | CT |
| Zip Code | 06824 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Neal A Fischbach Md | 111 Beach Rd, Fairfield, CT 06824 | Physician/surgeon | 2020-07-01 ~ 2021-06-30 |
| Fereshteh Ahmadian Md | 111 Beach Rd, Fairfield, CT 06484 | Physician/surgeon | 2020-05-01 ~ 2021-04-30 |
| Smilow Cancer Hospital Fairfield Treatment Center | 111 Beach Rd, Fairfield, CT 06824-6668 | Controlled Substance Registration for Hospitals | 2019-03-01 ~ 2021-02-28 |
| David J Wohl | 111 Beach Rd, Fairfield, CT 06430 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Patricia A Bendick | 111 Beach Rd, Fairfield, CT 06824 | Dentist | 2019-10-01 ~ 2020-09-30 |
| Kevin Strong Md | 111 Beach Rd, Fairfield, CT 06824 | Physician/surgeon | 2008-08-20 ~ 2009-09-30 |
| Robert Friedman Dds | 111 Beach Rd, Fairfield, CT 06430 | Controlled Substance Registration for Practitioner | 2007-03-01 ~ 2008-02-29 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Amy S Van Buren | 11 Larkspur Road, Fairfield, CT 06824 | Massage Therapist | 2020-08-01 ~ 2022-07-31 |
| Linda J Batchelder | 72 Ruane St, Fairfield, CT 06824 | Architect | 2020-08-01 ~ 2021-07-31 |
| Fairfield American Little League | 87 Charles St, Fairfield, CT 06824 | Public Charity | 2020-12-01 ~ 2021-11-30 |
| Robert D Sickeler | 175 Wakeman Rd, Fairfield, CT 06824 | Architect | 2020-08-01 ~ 2021-07-31 |
| Michael P Brennan | 338 Sturges Rd, Fairfield, CT 06824 | Real Estate Salesperson | 2020-06-23 ~ 2021-05-31 |
| Maria A Arduini | 499 Hemlock Rd, Fairfield, CT 06824 | Real Estate Salesperson | 2020-06-23 ~ 2021-05-31 |
| Ryan L Antisdale | 104 Rhoda Avenue, Fairfield, CT 06824 | Real Estate Salesperson | 2020-06-23 ~ 2021-05-31 |
| Szymlinska Eva Jucelin | 105 Churchill Street, Fairfield, CT 06824 | Licensed Practical Nurse | 2020-07-01 ~ 2021-06-30 |
| Afoofa, Inc · Afoofa | 298 South Benson Road, Fairfield, CT 06824 | Public Charity-exempt From Financial Requirements | 2020-06-25 ~ |
| Rachel Finlaw | 2546 North Benson Road, Fairfield, CT 06824 | Master's Level Social Worker | ~ |
| Find all Licenses in zip 06824 | |||
| City | FAIRFIELD |
| Zip Code | 06824 |
| License Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| License Type + County | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER + FAIRFIELD |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Paul H Pronovost Md | 5 Hunting Ridge Road, Easton, CT 06612 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Thomas A Pronovost · T A Pronovost Remodeling | 697 Woodtick Rd, Waterbury, CT 06705 | Home Improvement Contractor | 2009-12-01 ~ 2010-11-30 |
| Mary G Boy | 237 Clift St, Mystic, CT 06355-1726 | Controlled Substance Registration for Practitioner | 2018-12-20 ~ 2021-02-28 |
| Mary J O | 109 E Gate Ln, Hamden, CT 06514-2233 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Mary B O'malley | Po Box 447, Housatonic, MA 01236-0447 | Controlled Substance Registration for Practitioner | 2020-02-28 ~ 2021-02-28 |
| Mary Geiser Pa-c | 100 Grand St, New Britain, CT 06052-2016 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Mary M Harkin Md | 398 Route 148, Killingworth, CT 06419 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Mary A Arwady | 321 Grandview Ave Fl 3, Waterbury, CT 06708-2228 | Controlled Substance Registration for Practitioner | 2013-03-01 ~ 2015-02-28 |
| Mary E Eslick | 59 Sachem St, Norwich, CT 06360 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Renee Simone | 71 Mary St, Chicopee, MA 01020-1139 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
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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).