MARISE ST. CHARLES DO
Controlled Substance Registration for Practitioner


Address: 15 Massasoit St, Hyde Park, MA 02136

MARISE ST. CHARLES DO (Credential# 491907) is licensed (Controlled Substance Registration for Practitioner) with Connecticut Department of Consumer Protection. The license effective date is March 1, 2011. The license expiration date date is February 28, 2013. The license status is INACTIVE.

Business Overview

MARISE ST. CHARLES DO is licensed with the Department of Consumer Protection of Connecticut. The credential number is #CSP.0043006. The credential type is controlled substance registration for practitioner. The effective date is March 1, 2011. The expiration date is February 28, 2013. The business address is 15 Massasoit St, Hyde Park, MA 02136. The current status is inactive.

Basic Information

Licensee Name MARISE ST. CHARLES DO
Credential ID 491907
Credential Number CSP.0043006
Credential Type CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER
Business Address 15 Massasoit St
Hyde Park
MA 02136
Business Type INDIVIDUAL
Status INACTIVE
Issue Date 2008-01-08
Effective Date 2011-03-01
Expiration Date 2013-02-28
Refresh Date 2014-01-29

Other licenses

ID Credential Code Credential Type Issue Term Status
563325 1.045743-DO Physician/Surgeon 2007-08-07 2011-06-01 - 2012-05-31 INACTIVE

Office Location

Street Address 15 MASSASOIT ST
City HYDE PARK
State MA
Zip Code 02136

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Olufemi M Olukoga 22 Monponset St, Hyde Park, MA 02136 Pharmacist 2016-02-01 ~ 2018-01-31
Smh Fine Foods Inc 139 Milton Ave, Hyde Park, MA 02136 Bakery 2003-04-09 ~ 2003-06-30
David W Richards 1 Lawton Terr, Readville, MA 02136 Crane Operator 1984-10-01 ~ 1986-09-30
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Competitor

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City HYDE PARK
Zip Code 02136
License Type CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER
License Type + County CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER + HYDE PARK

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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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