CHRISTINE A BLAKE APRN
Controlled Substance Registration for Practitioner


Address: 38 Tallwood Dr, South Windsor, CT 06074-2914

CHRISTINE A BLAKE APRN (Credential# 492060) is licensed (Controlled Substance Registration for Practitioner) with Connecticut Department of Consumer Protection. The license effective date is March 1, 2015. The license expiration date date is February 28, 2017. The license status is INACTIVE.

Business Overview

CHRISTINE A BLAKE APRN is licensed with the Department of Consumer Protection of Connecticut. The credential number is #CSP.0043013. The credential type is controlled substance registration for practitioner. The effective date is March 1, 2015. The expiration date is February 28, 2017. The business address is 38 Tallwood Dr, South Windsor, CT 06074-2914. The current status is inactive.

Basic Information

Licensee Name CHRISTINE A BLAKE APRN
Credential ID 492060
Credential Number CSP.0043013
Credential Type CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER
Business Address 38 Tallwood Dr
South Windsor
CT 06074-2914
Business Type INDIVIDUAL
Status INACTIVE
Issue Date 2008-01-10
Effective Date 2015-03-01
Expiration Date 2017-02-28
Refresh Date 2018-01-29

Other licenses

ID Credential Code Credential Type Issue Term Status
681905 12.003727 Advanced Practice Registered Nurse 2007-12-17 2014-09-01 - 2015-08-31 INACTIVE
568636 10.064627 Registered Nurse 2000-10-02 2014-09-01 - 2015-08-31 INACTIVE

Office Location

Street Address 38 TALLWOOD DR
City SOUTH WINDSOR
State CT
Zip Code 06074-2914

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Cameron N Reyes 80 Tallwood Dr, South Windsor, CT 06074-2914 Emergency Medical Technician 2019-10-07 ~ 2022-09-30

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Competitor

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City SOUTH WINDSOR
Zip Code 06074
License Type CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER
License Type + County CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER + SOUTH WINDSOR

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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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