MARIA MANUELA DA COSTA
Controlled Substance Registration for Practitioner


Address: 836 Farmington Ave Ste 102, West Hartford, CT 06119-1544

MARIA MANUELA DA COSTA (Credential# 222761) 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.

Business Overview

MARIA MANUELA DA COSTA is licensed with the Department of Consumer Protection of Connecticut. The credential number is #CSP.0028845. 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 836 Farmington Ave Ste 102, West Hartford, CT 06119-1544. The current status is active.

Basic Information

Licensee Name MARIA MANUELA DA COSTA
Credential ID 222761
Credential Number CSP.0028845
Credential Type CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER
Business Address 836 Farmington Ave Ste 102
West Hartford
CT 06119-1544
Business Type INDIVIDUAL
Status ACTIVE - CURRENT
Active 1
Issue Date 1999-11-09
Effective Date 2019-03-01
Expiration Date 2021-02-28
Refresh Date 2019-01-28

Other licenses

ID Credential Code Credential Type Issue Term Status
546848 1.027909 Physician/Surgeon 1987-07-31 2019-08-01 - 2020-07-31 ACTIVE

Office Location

Street Address 836 FARMINGTON AVE STE 102
City WEST HARTFORD
State CT
Zip Code 06119-1544

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John A Gannatti 836 Farmington Ave Ste 120, West Hartford, CT 06119-1544 Controlled Substance Registration for Practitioner 2017-03-01 ~ 2019-02-28
Wei An 836 Farmington Ave Ste 207, West Hartford, CT 06119-1544 Controlled Substance Registration for Practitioner 2019-03-01 ~ 2021-02-28
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Stephen R Dewey 68 Richard St, W Hartford, CT 06119 Architect 2020-08-01 ~ 2021-07-31
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Judith Briggs 29 Troy St, West Hartford, CT 06119 Registered Nurse 2020-07-01 ~ 2021-06-30
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Competitor

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City WEST HARTFORD
Zip Code 06119
License Type CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER
License Type + County CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER + WEST HARTFORD

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Dataset Information

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).

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