MARY ANN S PUDIMAT MD (Credential# 221387) 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 ANN S PUDIMAT MD is licensed with the Department of Consumer Protection of Connecticut. The credential number is #CSP.0028762. 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 61 Emerald Glen Lane, Salem, CT 06420. The current status is active.
| Licensee Name | MARY ANN S PUDIMAT MD |
| Credential ID | 221387 |
| Credential Number | CSP.0028762 |
| Credential Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| Business Address |
61 Emerald Glen Lane Salem CT 06420 |
| Business Type | INDIVIDUAL |
| Status | ACTIVE - CURRENT |
| Active | 1 |
| Issue Date | 1999-09-24 |
| Effective Date | 2019-03-01 |
| Expiration Date | 2021-02-28 |
| Refresh Date | 2019-01-31 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 555551 | 1.037961 | Physician/Surgeon | 1999-07-16 | 2019-12-01 - 2020-11-30 | ACTIVE |
| Street Address | 61 EMERALD GLEN LANE |
| City | SALEM |
| State | CT |
| Zip Code | 06420 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Paul A Pudimat Md | 61 Emerald Glen Lane, Salem, CT 06420 | Physician/surgeon | 2020-08-01 ~ 2021-07-31 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Debra I Delorimiere | 322 Round Hill Road, Salem, CT 06420 | Real Estate Salesperson | ~ |
| Darci J Smith | 25 Salem Ridge Drive, Salem, CT 06420 | Hairdresser/cosmetician | 2020-07-01 ~ 2022-06-30 |
| Pamela Minella | 135 Sullivan Rd., Salem, CT 06420 | Water Treatment Plant Operator - Class Iv | 2020-04-01 ~ 2023-03-31 |
| Alfreda Shapere · Bingham | 170 Darling Rd, Salem, CT 06420 | Licensed Clinical Social Worker | 2020-09-01 ~ 2021-08-31 |
| Thomas J Butcher | 248 Norwich Road, Salem, CT 06420 | Professional Counselor | 2020-08-01 ~ 2021-07-31 |
| Destiny Faye Henkel | 65 Horse Pond Rd, Salem, CT 06420 | Master's Level Social Worker - Temporary Permit | 2020-06-12 ~ 2020-09-13 |
| Kevin R Fennell | 105 Witter Road, Salem, CT 06420 | Real Estate Salesperson | 2020-06-01 ~ 2021-05-31 |
| Scott D Pellerin | 301 Rattlesnake Ledge Road, Salem, CT 06420 | Real Estate Salesperson | 2020-06-01 ~ 2021-05-31 |
| Salem Prime Cuts Inc · John Fusaro Jr | 12 New London Rd, Salem, CT 06420 | Bakery | 2020-07-01 ~ 2021-06-30 |
| Sarah L Maiorano | 130 Music Vale Road, Salem, CT 06420 | Registered Nurse | 2020-06-01 ~ 2021-05-31 |
| Find all Licenses in zip 06420 | |||
| City | SALEM |
| Zip Code | 06420 |
| License Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| License Type + County | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER + SALEM |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| George Pudimat · George Pudimat Painting | 13 Joyce Ave, Derby, CT 06418 | Home Improvement Contractor | 2019-12-01 ~ 2020-11-30 |
| Mary J O | 109 E Gate Ln, Hamden, CT 06514-2233 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Mary G Boy | 237 Clift St, Mystic, CT 06355-1726 | Controlled Substance Registration for Practitioner | 2018-12-20 ~ 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 R Benoit | 1 Ambler Rd, Bristol, CT 06010-3523 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Mary Mcneel Pa | 28 Ledgeway Rd, Redding, CT 06896 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Mary E Savage | 81 Mckinley Ave, New Haven, CT 06515-2733 | Controlled Substance Registration for Practitioner | 2019-04-30 ~ 2021-02-28 |
| Mary E Leahy | 31 Brook Dr, Simsbury, CT 06070-1534 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Amy Alias Md | St Mary's Hospital, Waterbury, CT 06706 | Controlled Substance Registration for Practitioner | 2008-03-01 ~ 2009-02-28 |
| Mary Flanigan | 17 Case St, Norwich, CT 06360-2208 | Controlled Substance Registration for Practitioner | 2020-01-09 ~ 2021-02-28 |
Please comment or provide details below to improve the information on MARY ANN S PUDIMAT MD.
| 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).