IVELISSE RIVERA-GODREAU MD (Credential# 517471) 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.
IVELISSE RIVERA-GODREAU MD is licensed with the Department of Consumer Protection of Connecticut. The credential number is #CSP.0044776. 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 331 Bush Hill Rd, Manchester, CT 06040. The current status is active.
| Licensee Name | IVELISSE RIVERA-GODREAU MD |
| Credential ID | 517471 |
| Credential Number | CSP.0044776 |
| Credential Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| Business Address |
331 Bush Hill Rd Manchester CT 06040 |
| Business Type | INDIVIDUAL |
| Status | ACTIVE - CURRENT |
| Active | 1 |
| Issue Date | 2008-10-29 |
| Effective Date | 2019-03-01 |
| Expiration Date | 2021-02-28 |
| Refresh Date | 2019-01-22 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 564670 | 1.047088 | Physician/Surgeon | 2008-10-16 | 2019-10-01 - 2020-09-30 | ACTIVE |
| Street Address | 331 Bush Hill Rd |
| City | Manchester |
| State | CT |
| Zip Code | 06040 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Mary Fosuah Nketia | 61 Cougar Drive, Manchester, CT 06040 | Registered Nurse | 2020-08-01 ~ 2021-07-31 |
| New Seasons Inc. | 164 East Center Street, Manchester, CT 06040 | Public Charity | 2019-06-01 ~ 2020-05-31 |
| Kaylen Lam | 60 Chlistone Lane, Manchester, CT 06040 | Combination Nail Technician, Esthetician Or Eyelash Technici | ~ |
| Matilde Altamirano | 415 Gardner Street, Manchester, CT 06040 | Nail Technician | 2020-06-27 ~ 2022-04-30 |
| Meilan Meilan Chen | 174 Middle Tpke, Manchester, CT 06040 | Nail Technician | ~ |
| Prince Acheampong | 32 Bigelow Street, Manchester, CT 06040 | Notary Public Appointment | ~ |
| Erin C Boyle | 470 Porter Street, Manchester, CT 06040 | Registered Nurse | 2020-07-01 ~ 2021-06-30 |
| Dejone Mitchell | 64 Ruby Dr Apt. P, Manchester, CT 06040 | Combination Nail Technician, Esthetician Or Eyelash Technici | ~ |
| Andrea H Clifford | 116 Longview Drive, Manchester, CT 06040 | Licensed Practical Nurse | 2020-09-01 ~ 2021-08-31 |
| Tabia Thornton-bey | 103 Walek Farms Road, Manchester, CT 06040 | Licensed Clinical Social Worker | 2020-07-01 ~ 2021-06-30 |
| Find all Licenses in zip 06040 | |||
| City | Manchester |
| Zip Code | 06040 |
| License Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| License Type + County | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER + Manchester |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Marta Rivera Md | Po Box 2203, Chesapeake, VA 23327-2203 | Controlled Substance Registration for Practitioner | 2011-03-01 ~ 2013-02-28 |
| Jorge M Rivera | 92 Horseshoe Rd, Guilford, CT 06437-2918 | Controlled Substance Registration for Practitioner | 2019-06-11 ~ 2021-02-28 |
| Gustavo Rivera Md | 72 Jaques Ave, Worcester, MA 01610 | Controlled Substance Registration for Practitioner | 2001-03-01 ~ 2002-02-28 |
| Carmen Rivera | 282 Washington St, Hartford, CT 06106-3322 | Controlled Substance Registration for Practitioner | 2008-07-17 ~ 2009-02-28 |
| Carlos Rivera | 24 Hospital Ave, Danbury, CT 06810 | Controlled Substance Registration for Practitioner | 2009-09-02 ~ 2011-02-28 |
| Leevette Rivera | 34 Rockland St., Wethersfield, CT 06109 | Controlled Substance Registration for Practitioner | 2019-10-22 ~ 2021-02-28 |
| Kathleen R Rivera | 23 Poplar St, New Milford, CT 06776 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Arnold Dc Rivera | 111 New Haven Ave, Derby, CT 06418-2197 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Nelza Rivera-competiello Md | 139 Hazard Ave, Enfield, CT 06082-4585 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Hector L Rivera | 196 Lexington Avenue, New Haven, CT 06513 | Controlled Substance Registration for Practitioner | 2011-03-01 ~ 2013-02-28 |
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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).