ELIZA M FANTARELLA (Credential# 476519) 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.
ELIZA M FANTARELLA is licensed with the Department of Consumer Protection of Connecticut. The credential number is #CSP.0041869. 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 1125 Ridge Rd, North Haven, CT 06473-4436. The current status is active.
| Licensee Name | ELIZA M FANTARELLA |
| Credential ID | 476519 |
| Credential Number | CSP.0041869 |
| Credential Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| Business Address |
1125 Ridge Rd North Haven CT 06473-4436 |
| Business Type | INDIVIDUAL |
| Status | ACTIVE - CURRENT |
| Active | 1 |
| Issue Date | 2007-08-03 |
| Effective Date | 2019-03-01 |
| Expiration Date | 2021-02-28 |
| Refresh Date | 2018-12-28 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 932290 | 19.000867 | Podiatrist | 2010-06-15 | 2020-01-01 - 2020-12-31 | ACTIVE |
| Street Address | 1125 RIDGE RD |
| City | NORTH HAVEN |
| State | CT |
| Zip Code | 06473-4436 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Leslie M Dellavalle | 1137 Ridge Rd, North Haven, CT 06473-4436 | Real Estate Salesperson | 2020-06-01 ~ 2021-05-31 |
| Edmund T Della Valle | 1137 Ridge Rd, North Haven, CT 06473-4436 | Real Estate Broker | 2013-04-01 ~ 2014-03-31 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Renee A Rollier | 90 Fallon Drive, North Haven, CT 06473 | Registered Nurse | 2020-07-01 ~ 2021-06-30 |
| Carly J Brueggestrat Aprn | 191 Cloudland Rd, North Haven, CT 06473 | Registered Nurse | 2020-08-01 ~ 2021-07-31 |
| Heesuk Hyun | 769 Middletown Ave, North Haven, CT 06473 | Combination Nail Technician, Esthetician Or Eyelash Technici | ~ |
| Jacqueline N Sancho | 9 Corey Rd, North Haven, CT 06473 | Physical Therapist Assistant | 2020-08-01 ~ 2021-07-31 |
| Irene L Smith | 35 Debra Lane, North Haven, CT 06473 | Radiographer | 2020-08-01 ~ 2021-07-31 |
| Jane S Jane | 380 Skiff Street, North Haven, CT 06473 | Psychologist | 2020-09-01 ~ 2021-08-31 |
| Shana Kathleen Lipp | [email protected], North Haven, CT 06473 | Combination Nail Technician, Esthetician Or Eyelash Technici | ~ |
| Haifeng Piao | 201 Universal Drive, North Haven, CT 06473 | Nail Technician | ~ |
| Xuefan Piao | 32 Lexington Gardens, North Haven, CT 06473 | Nail Technician | ~ |
| Zachary A Cuzzocreo | 45 Thorpe Street, North Haven, CT 06473 | Real Estate Salesperson | 2020-06-20 ~ 2021-05-31 |
| Find all Licenses in zip 06473 | |||
| City | NORTH HAVEN |
| Zip Code | 06473 |
| License Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| License Type + County | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER + NORTH HAVEN |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| David M Fantarella Dmd | 127 Washington Avenue, North Haven, CT 06473 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Natasha Hameed | 34 Eliza Ln Apt 121, Bloomfield, CT 06002-5471 | Controlled Substance Registration for Practitioner | 2019-04-12 ~ 2021-02-28 |
| Eliza M Martel | 6 Laurel Ridge Rd, Southwick, MA 01077-9225 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Mariel Eliza | 1 Schooner Lane Apt 2c, Milford, CT 06460 | Controlled Substance Registration for Practitioner | 2005-03-01 ~ 2006-02-28 |
| Eliza Christine Buelt | 34 Park Street, New Haven, CT 06519 | Controlled Substance Registration for Practitioner | 2019-05-09 ~ 2021-02-28 |
| Eliza-jasmine B Tran Md | Breast Center, New Haven, CT 06519 | Controlled Substance Registration for Practitioner | 2009-10-05 ~ 2011-02-28 |
| Eliza Holland | 49 Rock Hill Road, Woodbridge, CT 06525 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Eliza J Newman | 45 A Brookwood Drive, Rocky Hill, CT 06067 | Controlled Substance Registration for Practitioner | 2013-08-27 ~ 2015-02-28 |
| Eliza R Valenzuela | 263 Farmington Ave L2104 Mc-1235, Farmington, CT 06030 | Controlled Substance Registration for Practitioner | 2008-03-01 ~ 2009-02-28 |
| Steven Kassels Md · Community Substance Abuse Center | Comm. Physicians PC/125 North Elm Street, Westfield, MA 01085 | Controlled Substance Registration for Practitioner | 2018-06-15 ~ 2019-02-28 |
Please comment or provide details below to improve the information on ELIZA M FANTARELLA.
| 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).