MELANIE J KOUMENTAKOS (Credential# 471493) 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.
MELANIE J KOUMENTAKOS is licensed with the Department of Consumer Protection of Connecticut. The credential number is #CSP.0041519. 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 1 Gary Dr, Westfield, MA 01085-4553. The current status is active.
| Licensee Name | MELANIE J KOUMENTAKOS |
| Credential ID | 471493 |
| Credential Number | CSP.0041519 |
| Credential Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| Business Address |
1 Gary Dr Westfield MA 01085-4553 |
| Business Type | INDIVIDUAL |
| Status | ACTIVE - CURRENT |
| Active | 1 |
| Issue Date | 2007-05-21 |
| Effective Date | 2019-03-01 |
| Expiration Date | 2021-02-28 |
| Refresh Date | 2019-01-28 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 743654 | 23.001905 | Physician Assistant | 2007-05-01 | 2019-06-01 - 2020-05-31 | ACTIVE |
| Street Address | 1 GARY DR |
| City | WESTFIELD |
| State | MA |
| Zip Code | 01085-4553 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Katie M Winslow | 33 Cara Lane, Westfield, MA 01085 | Registered Nurse | 2020-06-20 ~ 2021-06-30 |
| Diana P Wigham | 1031 East Mountain Road, Westfield, MA 01085 | Registered Nurse | 2020-07-01 ~ 2021-06-30 |
| Cathy A Roche | 56 Pequot Point Rd., Westfield, MA 01085 | Physical Therapist Assistant | 2020-08-01 ~ 2021-07-31 |
| James Richard Vollinger | 139 Union Street, Westfield, MA 01085 | Registered Nurse | 2020-07-01 ~ 2021-06-30 |
| Sharon L Scavotto | 196 Tannery Road, Westfield, MA 01085 | Notary Public Appointment | 2020-10-01 ~ 2025-09-30 |
| Christopher J Ferrero | 64 Ridge Trail Rd, Westfield, MA 01085 | Landscape Architect | 2020-08-01 ~ 2021-07-31 |
| Aimee C Tompkins | 2 Birch Terr, Westfield, MA 01085 | Real Estate Salesperson | 2019-06-01 ~ 2020-05-31 |
| Jennifer B Wilson | 33 Raymond Cir, Westfield, MA 01085 | Real Estate Salesperson | 2020-06-01 ~ 2021-05-31 |
| Patricia S Daley | 152 Elizabeth Ave, Westfield, MA 01085 | Registered Nurse | 2020-01-01 ~ 2020-12-31 |
| Cheryl-ann J Koval | 171 Wildflower Cir, Westfield, MA 01085 | Real Estate Salesperson | 2020-06-01 ~ 2021-05-31 |
| Find all Licenses in zip 01085 | |||
| City | WESTFIELD |
| Zip Code | 01085 |
| License Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| License Type + County | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER + WESTFIELD |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Melanie M Liu | 900 Chapel St Apt 312, New Haven, CT 06510-2802 | Controlled Substance Registration for Practitioner | 2012-07-13 ~ 2013-02-28 |
| Melanie J Rudnick | 10 Francis Way Apt 361, Bloomfield, CT 06002 | Controlled Substance Registration for Practitioner | 2015-03-01 ~ 2017-02-28 |
| Melanie L Church | 42 Benefit St, Warwick, RI 02886-6702 | Controlled Substance Registration for Practitioner | 2013-11-16 ~ 2015-02-28 |
| Melanie S. Kelton Md | 8 Myrtledale Rd, Scarsdale, NY 10583-7336 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Melanie F Estrella | 16 Henry St, Manchester, CT 06042-3523 | Controlled Substance Registration for Practitioner | 2015-05-27 ~ 2017-02-28 |
| Melanie F Paradis | 171 Forsyth Rd, Salem, CT 06420-4037 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Melanie Kay Hosker | 31 Monroe St Apt 4, Branford, CT 06405-3048 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Melanie Pascal | 20 York St, New Haven, CT 06510-3220 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Melanie A Lentini | 37 Perkins St, Bristol, CT 06010-2926 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Melanie Mckeever | 1 Bradbury Rd, New Milford, CT 06776-2501 | 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).