DONNA M WALLACE APRN (Credential# 511904) 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.
DONNA M WALLACE APRN is licensed with the Department of Consumer Protection of Connecticut. The credential number is #CSP.0044453. 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 180 Regency Terrace, Stratford, CT 06615. The current status is active.
Licensee Name | DONNA M WALLACE APRN |
Credential ID | 511904 |
Credential Number | CSP.0044453 |
Credential Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
Business Address |
180 Regency Terrace Stratford CT 06615 |
Business Type | INDIVIDUAL |
Status | ACTIVE - CURRENT |
Active | 1 |
Issue Date | 2008-08-19 |
Effective Date | 2019-03-01 |
Expiration Date | 2021-02-28 |
Refresh Date | 2019-01-22 |
ID | Credential Code | Credential Type | Issue | Term | Status |
---|---|---|---|---|---|
575283 | 10.071277 | Registered Nurse | 2003-06-24 | 2019-09-01 - 2020-08-31 | ACTIVE |
682018 | 12.003840 | Advanced Practice Registered Nurse | 2008-08-04 | 2019-09-01 - 2020-08-31 | ACTIVE |
Street Address | 180 REGENCY TERRACE |
City | Stratford |
State | CT |
Zip Code | 06615 |
Licensee Name | Office Address | Credential | Effective / Expiration |
---|---|---|---|
Naomi M Ragsdale | 180 Regency Terrace, Stratford, CT 06615 | Licensed Clinical Social Worker | 2017-11-01 ~ 2018-10-31 |
Licensee Name | Office Address | Credential | Effective / Expiration |
---|---|---|---|
Sarath Koun | 323 Bruce Ave, Stratford, CT 06615 | Combination Nail Technician, Esthetician Or Eyelash Technici | 2020-06-27 ~ 2022-03-31 |
Constance Trenske | 50 Birdseye Street, #105a, Stratford, CT 06615 | Registered Nurse | 2020-09-01 ~ 2021-08-31 |
Jennifer Massey | 187 Third Ave, Stratford, CT 06615 | Notary Public Appointment | 2020-08-01 ~ 2025-07-31 |
Regina M Golden | 295 2nd Ave, Stratford, CT 06615 | Real Estate Salesperson | 2020-06-25 ~ 2021-05-31 |
Susan R Leventhal | 265 Second Ave, Stratford, CT 06615 | Registered Nurse | 2020-09-01 ~ 2021-08-31 |
Danielle M Donfrancesco | 90 Sands Pl, Stratford, CT 06615 | Esthetician | ~ |
James A Phillips | 735 Broad Street, Stratford, CT 06615 | Backflow Prevention Device Tester | 2020-05-27 ~ 2023-03-31 |
Debra J Cennamo | 155 Short Beach Rd, Stratford, CT 06615 | Hairdresser/cosmetician | 2020-09-01 ~ 2022-08-31 |
Melissa Andrea Escobar-avilez | Melissaescobar129@gmail.com, Stratford, CT 06615 | Licensed Practical Nurse | ~ |
Stephanie Gabon | 1168 Main Street, C6, Stratford, CT 06615 | Licensed Practical Nurse | ~ |
Find all Licenses in zip 06615 |
City | Stratford |
Zip Code | 06615 |
License Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
License Type + County | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER + Stratford |
Licensee Name | Office Address | Credential | Effective / Expiration |
---|---|---|---|
Donna M Avanecean Aprn | 239 Windham Rd, Brooklyn, CT 06234 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
Donna M Delpo Aprn | 117 Metacomet Rd, Plainville, CT 06062 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
Donna L Russell Aprn | 6 E Applewood Dr, Charlton, MA 01507-1600 | Controlled Substance Registration for Practitioner | 2009-04-08 ~ 2011-02-28 |
Donna L Yasick Aprn | 3 Ariel Road, Woodbridge, CT 06525 | Controlled Substance Registration for Practitioner | 2017-03-01 ~ 2019-02-28 |
Donna Poeta Aprn | 3 Bayberry Ridge Rd, Old Lyme, CT 06371 | Controlled Substance Registration for Practitioner | 2017-03-01 ~ 2019-02-28 |
Donna Holt Aprn | 14 Brook Crossway, Greenwich, CT 06831-4102 | Controlled Substance Registration for Practitioner | 1997-03-01 ~ 1998-02-28 |
Donna H Hoskins Aprn | 38 White Hollow Rd, Sharon, CT 06069-2118 | Controlled Substance Registration for Practitioner | 2019-06-26 ~ 2021-02-28 |
Donna Defelice Aprn | 114 Mountain View Road, Glastonbury, CT 06033 | Controlled Substance Registration for Practitioner | 2011-03-01 ~ 2013-02-28 |
Donna L Ford Aprn | 1111 Cromwell Ave, Rocky Hill, CT 06067 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
Donna Collins Aprn | Danbury Hospital Anesthesiology, Danbury, CT 06810 | Controlled Substance Registration for Practitioner | 2009-03-01 ~ 2011-02-28 |
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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).