KEITH E GIPSON (Credential# 509732) 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.
KEITH E GIPSON is licensed with the Department of Consumer Protection of Connecticut. The credential number is #CSP.0044086. 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 986 N Farms Rd, Wallingford, CT 06492-1808. The current status is active.
| Licensee Name | KEITH E GIPSON |
| Credential ID | 509732 |
| Credential Number | CSP.0044086 |
| Credential Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| Business Address |
986 N Farms Rd Wallingford CT 06492-1808 |
| Business Type | INDIVIDUAL |
| Status | ACTIVE - CURRENT |
| Active | 1 |
| Issue Date | 2008-08-05 |
| Effective Date | 2019-03-01 |
| Expiration Date | 2021-02-28 |
| Refresh Date | 2019-01-25 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 1047643 | 1.050552 | Physician/Surgeon | 2012-01-24 | 2019-12-01 - 2020-11-30 | ACTIVE |
| 1053816 | CSP.0052036 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | - | INACTIVE |
| Street Address | 986 N FARMS RD |
| City | WALLINGFORD |
| State | CT |
| Zip Code | 06492-1808 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Felicia Thai Heath | 986 N Farms Rd, Wallingford, CT 06492-1808 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Jillian P Sipperly | 1093 Prospect Ave, West Hartford, CT 06492-1808 | Registered Nurse | 2020-05-01 ~ 2021-04-30 |
| Debra R. Wilcox | 936 N Farms Rd, Wallingford, CT 06492-1808 | Optician | 2020-01-01 ~ 2020-12-31 |
| Mary L Pease | 948 N Farms Rd, Wallingford, CT 06492-1808 | Physical Therapist | 2020-01-01 ~ 2020-12-31 |
| Henriqueta R Moutinho | 952 N Farms Rd, Wallingford, CT 06492-1808 | Licensed Practical Nurse | 2019-10-01 ~ 2020-09-30 |
| K.c Construction of Wallingford LLC | 948 N Farms Rd, Wallingford, CT 06492-1808 | Home Improvement Contractor | 2020-01-15 ~ 2020-11-30 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Andrea Zola | 53 Alison Ave., Wallingford, CT 06492 | Esthetician | ~ |
| Kyungok Choi | 90 Ward St, Wallingford, CT 06492 | Combination Nail Technician, Esthetician Or Eyelash Technici | ~ |
| Giang Nguyen | 45 Country Club Lane, Wallingford, CT 06492 | Combination Nail Technician, Esthetician Or Eyelash Technici | 2020-06-27 ~ 2021-11-30 |
| Lc Artistry | 207 North Colony Road, Wallingford, CT 06492 | Esthetician | ~ |
| Katie Lee | 20 Angela Dr, Wallingford, CT 06492 | Paramedic | 2020-09-01 ~ 2021-08-31 |
| Vinny's Deli | 567 Center St, Wallingford, CT 06492 | Operator of Weighing & Measuring Devices | 2020-08-01 ~ 2021-07-31 |
| Michele Ruggiero | 26 Leigus Road, Wallingford, CT 06492 | Radiographer | 2020-07-01 ~ 2021-06-30 |
| Dianna K Ball | 104 Simpson Ave, Wallingford, CT 06492 | Speech and Language Pathologist | 2020-08-01 ~ 2021-07-31 |
| Ann Marie Richardson | 20 Mohawk Drive, Wallingford, CT 06492 | Registered Nurse | 2020-07-01 ~ 2021-06-30 |
| Joann Hummel | 60 Deer Run Road, Wallingford, CT 06492 | Medication Administration Certification | 2018-08-21 ~ 2020-08-20 |
| Find all Licenses in zip 06492 | |||
| City | WALLINGFORD |
| Zip Code | 06492 |
| License Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| License Type + County | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER + WALLINGFORD |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Keith Gipson | 986 North Farms Rd., Wallingford, CT 06496 | Honey Bee Registration | 2012-01-01 ~ 2012-12-31 |
| Keith Hollinger | 55 Nye Rd Ste 101, Glastonbury, CT 06033-1281 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Keith P Cross | 925 Mix Ave Apt 1-h, Hamden, CT 06514 | Controlled Substance Registration for Practitioner | 2007-03-01 ~ 2008-02-29 |
| Matthew P Ward | 47 Keith Cir, Killingworth, CT 06419-1453 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Keith M Gottesdiener | 900 Fifth Avenue, New York, NY 10021 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Keith E Penney Md | 538 Litchfield St Ste G01, Torrington, CT 06790-6669 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Keith H Wade | 101 Main St S, Bethlehem, CT 06751-2032 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Keith J. Falter II | 90 Locust Ave, Danbury, CT 06810-6034 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Keith Vom Eigen Md | 131 Coventry St, Hartford, CT 06112 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Keith L Ellis | 16 Spring St, Chester, CT 06412-1335 | 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).