AMANDA N KALLEN MD (Credential# 479720) 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.
AMANDA N KALLEN MD is licensed with the Department of Consumer Protection of Connecticut. The credential number is #CSP.0042424. 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 Po Box 268, Middle Haddam, CT 06456. The current status is active.
Licensee Name | AMANDA N KALLEN MD |
Credential ID | 479720 |
Credential Number | CSP.0042424 |
Credential Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
Business Address |
Po Box 268 Middle Haddam CT 06456 |
Business Type | INDIVIDUAL |
Status | ACTIVE - CURRENT |
Active | 1 |
Issue Date | 2007-11-01 |
Effective Date | 2019-03-01 |
Expiration Date | 2021-02-28 |
Refresh Date | 2019-01-31 |
ID | Credential Code | Credential Type | Issue | Term | Status |
---|---|---|---|---|---|
936924 | 1.049244 | Physician/Surgeon | 2010-09-27 | 2019-08-01 - 2020-07-31 | ACTIVE |
Street Address | PO Box 268 |
City | Middle Haddam |
State | CT |
Zip Code | 06456 |
Licensee Name | Office Address | Credential | Effective / Expiration |
---|---|---|---|
Robert Lohrmann | Po Box 268, Middle Haddam, CT 06456 | Architect | 2009-08-01 ~ 2010-07-31 |
Licensee Name | Office Address | Credential | Effective / Expiration |
---|---|---|---|
John Joseph Muskatallo | 32 Keighley Pond Road, Middle Haddam, CT 06456 | Radiographer | 2020-08-01 ~ 2021-07-31 |
Stephanie Fuss | 19 High Point Drive, Middle Haddam, CT 06456 | Landscape Architect | 2020-08-01 ~ 2021-07-31 |
Pamela J Hatfield | 37 Fern Lane, Middle Haddam, CT 06456 | Real Estate Salesperson | 2020-06-01 ~ 2021-05-31 |
Amy M Howard | 145 Middle Haddam Road, Middle Haddam, CT 06456 | Real Estate Salesperson | 2020-06-01 ~ 2021-05-31 |
Gabriella Watstein | 33 Fern Ln, Middle Haddam, CT 06456 | Registered Sanitarian | 2020-05-01 ~ 2021-04-30 |
Patricia A Foust-day | 139 Middle Haddam Rd, Middle Haddam, CT 06456 | Real Estate Salesperson | 2020-06-01 ~ 2021-05-31 |
Judith A Keefe | P.o. Box 147, Middle Haddam, CT 06456 | Registered Nurse | 2020-03-01 ~ 2021-02-28 |
Katherine M Grant | 5 Knowles Rd, Middle Haddam, CT 06456 | Registered Nurse | 2020-03-01 ~ 2021-02-28 |
Maryann G Meehl | 39 High Point Drive, Middle Haddam, CT 06456 | Real Estate Broker | 2020-04-01 ~ 2021-03-31 |
Shawn J France II | 36 Middle Haddam Rd, Middle Haddam, CT 06456 | Home Improvement Salesperson | 2018-12-27 ~ 2019-11-30 |
Find all Licenses in zip 06456 |
City | Middle Haddam |
Zip Code | 06456 |
License Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
License Type + County | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER + Middle Haddam |
Licensee Name | Office Address | Credential | Effective / Expiration |
---|---|---|---|
Caleb B Kallen Md | 333 Cedar St, New Haven, CT 06520-8063 | Controlled Substance Registration for Practitioner | 2005-03-01 ~ 2006-02-28 |
Amanda H Uva | 6 Chiltern St, Farmington, CT 06032-1533 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
Amanda N Rea | 195 Broadmere Rd, Stratford, CT 06614 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
Amanda Lu | 71 Haynes St, Manchester, CT 06040-4131 | Controlled Substance Registration for Practitioner | 2019-05-29 ~ 2021-02-28 |
Michelle N Brenes Pa | 41 Amanda Cir, Windsor, CT 06095-3466 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
Amanda J Ponte | 11 South Rd Ste 250, Farmington, CT 06032-2484 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
Amanda M White | 5 Perryridge Rd, Greenwich, CT 06830-4608 | Controlled Substance Registration for Practitioner | 2013-03-01 ~ 2015-02-28 |
Amanda Holmes | 475 Bank St, Waterbury, CT 06708-3501 | Controlled Substance Registration for Practitioner | 2015-03-01 ~ 2017-02-28 |
Amanda J Maki Pa-c | 19 Davis Ave # A, Vernon, CT 06066-3101 | Controlled Substance Registration for Practitioner | 2015-03-01 ~ 2017-02-28 |
Amanda J Morvai | 39 Stonybrook Rd Ste 2, Stratford, CT 06614-3752 | Controlled Substance Registration for Practitioner | 2019-08-19 ~ 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).