KELLY A MARTENS PA (Credential# 324312) 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.
KELLY A MARTENS PA is licensed with the Department of Consumer Protection of Connecticut. The credential number is #CSP.0032887. 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 492 Shore Dr, Branford, CT 06405. The current status is active.
| Licensee Name | KELLY A MARTENS PA |
| Credential ID | 324312 |
| Credential Number | CSP.0032887 |
| Credential Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| Business Address |
492 Shore Dr Branford CT 06405 |
| Business Type | INDIVIDUAL |
| Status | ACTIVE - CURRENT |
| Active | 1 |
| Issue Date | 2002-11-18 |
| Effective Date | 2019-03-01 |
| Expiration Date | 2021-02-28 |
| Refresh Date | 2019-02-25 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 741989 | 23.000240 | Physician Assistant | 1993-10-22 | 2019-10-01 - 2020-09-30 | ACTIVE |
| Street Address | 492 SHORE DR |
| City | BRANFORD |
| State | CT |
| Zip Code | 06405 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| David R Goff | 492 Shore Dr, Branford, CT 06405 | Professional Engineer | 1992-05-18 ~ 1993-01-31 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Raymond M Johnson | 39 Bayberry Lane, Branford, CT 06405 | Physician/surgeon | 2020-07-01 ~ 2021-06-30 |
| Kirsten M Ranciato | 288 East Main Street, Branford, CT 06405 | Licensed Clinical Social Worker | 2020-08-01 ~ 2021-07-31 |
| Bimala Khadka Thapa | 726 Robert Frost Dr., Branford, CT 06405 | Nail Technician | ~ |
| Paul E Basile | 42 Valley Brook Road South, Branford, CT 06405 | Perfusionist | 2020-08-01 ~ 2021-07-31 |
| Lupe Monica Placencia-muy | 100 East Main Street 2nd Fl, Branford, CT 06405 | Combination Nail Technician, Esthetician Or Eyelash Technici | 2020-06-27 ~ 2022-02-28 |
| Bridget J Jennings | 159 Queach Road, Branford, CT 06405 | Registered Nurse | 2020-09-01 ~ 2021-08-31 |
| Ujeli Acharya | 21 Burban Drive, Branford, CT 06405 | Nail Technician | ~ |
| Cathleen Smith | 50 First Avenue, Branford, CT 06405 | Radiographer | 2020-07-01 ~ 2021-06-30 |
| Gita Thapa | 94 Village Lane, Branford, CT 06405 | Nail Technician | ~ |
| Cycle Venture Partners Fund I Lp - Lumeda Series 1 | 50 Limewood Avenue, Branford, CT 06405 | Securities - Exemptions | 2020-06-17 ~ |
| Find all Licenses in zip 06405 | |||
| City | BRANFORD |
| Zip Code | 06405 |
| License Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| License Type + County | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER + BRANFORD |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Patricia L Martens | 35 Fenwick Drive, Farmington, CT 06032 | Controlled Substance Registration for Practitioner | 2011-07-20 ~ 2013-02-28 |
| Richard F Martens · R F Martens | 193 Hanover Rd, Newtown, CT 06470-1103 | Home Improvement Contractor | 2010-12-01 ~ 2011-11-30 |
| Kelly Gullotta | Po Box 465, Brownsville, VT 05037-0465 | Controlled Substance Registration for Practitioner | 2020-04-09 ~ 2021-02-28 |
| Kelly M. Doran Md | New Haven, CT 06511 | Controlled Substance Registration for Practitioner | 2013-03-01 ~ 2015-02-28 |
| Kelly J Way | 34 B Springbrook Rd, Westerly, RI 02891 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Kelly M Ferjentsik | 34 Little Fox Ln, Monroe, CT 06468-1607 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Kelly M Deforest | 267 Rte 87, Columbia, CT 06237 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Kelly L Babineaux | 100 Temple St Ph 3, New Haven, CT 06510-2711 | Controlled Substance Registration for Practitioner | 2009-09-30 ~ 2011-02-28 |
| Kelly A Melchionno | 11 Erdmann Ln, Wilton, CT 06897-4612 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Kelly A Toth | 120 Mikayla Ln, Prospect, CT 06712-1497 | 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).