MARIE A BONITATIBUS APRN
Controlled Substance Registration for Practitioner


Address: 2490 Black Rock Turnpike, Fairfield, CT 06432

MARIE A BONITATIBUS APRN (Credential# 242873) is licensed (Controlled Substance Registration for Practitioner) with Connecticut Department of Consumer Protection. The license effective date is February 29, 2004. The license expiration date date is February 28, 2005. The license status is INACTIVE.

Business Overview

MARIE A BONITATIBUS APRN is licensed with the Department of Consumer Protection of Connecticut. The credential number is #CSP.0030011. The credential type is controlled substance registration for practitioner. The effective date is February 29, 2004. The expiration date is February 28, 2005. The business address is 2490 Black Rock Turnpike, Fairfield, CT 06432. The current status is inactive.

Basic Information

Licensee Name MARIE A BONITATIBUS APRN
Credential ID 242873
Credential Number CSP.0030011
Credential Type CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER
Business Address 2490 Black Rock Turnpike
Fairfield
CT 06432
Business Type INDIVIDUAL
Status INACTIVE
Effective Date 2004-02-29
Expiration Date 2005-02-28
Refresh Date 2009-01-26

Other licenses

ID Credential Code Credential Type Issue Term Status
630253 10.E61365 Registered Nurse 1999-07-16 2003-09-15 - 2004-09-30 INACTIVE
680505 12.002327 Advanced Practice Registered Nurse 2000-08-07 2003-09-15 - 2004-09-30 INACTIVE
670738 11.026907 Licensed Practical Nurse 1998-02-20 1998-09-30 - 1999-09-30 INACTIVE

Office Location

Street Address 2490 BLACK ROCK TURNPIKE
City FAIRFIELD
State CT
Zip Code 06432

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Kyma A Harrison 2490 Black Rock Turnpike, Fairfield, CT 06825 Notary Public Appointment 2011-07-08 ~ 2016-07-31
Guy F Preston 2490 Black Rock Turnpike, Fairfield, CT 06432-2400 Pharmacy Technician 1998-10-01 ~ 2000-03-31

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Linda M Ludwig 81 Valley Circle, Fairfield, CT 06432 Psychologist 2020-04-01 ~ 2021-03-31
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Competitor

Search similar business entities

City FAIRFIELD
Zip Code 06432
License Type CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER
License Type + County CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER + FAIRFIELD

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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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