PHILIP T JOHNSON APRN (Credential# 528567) 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.
PHILIP T JOHNSON APRN is licensed with the Department of Consumer Protection of Connecticut. The credential number is #CSP.0045302. 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 4712 Admiralty Way - 370, Marina Del Rey, CA 90292. The current status is active.
| Licensee Name | PHILIP T JOHNSON APRN |
| Credential ID | 528567 |
| Credential Number | CSP.0045302 |
| Credential Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| Business Address |
4712 Admiralty Way - 370 Marina Del Rey CA 90292 |
| Business Type | INDIVIDUAL |
| Status | ACTIVE - CURRENT |
| Active | 1 |
| Issue Date | 2009-04-01 |
| Effective Date | 2019-03-01 |
| Expiration Date | 2021-02-28 |
| Refresh Date | 2019-01-04 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 619717 | 10.E50535 | Registered Nurse | 1987-09-14 | 2020-02-01 - 2021-01-31 | ACTIVE |
| 682233 | 12.004055 | Advanced Practice Registered Nurse | 2009-03-18 | 2020-02-01 - 2021-01-31 | ACTIVE |
| Street Address | 4712 Admiralty Way - 370 |
| City | Marina Del Rey |
| State | CA |
| Zip Code | 90292 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Michael S Tamola | 3676 Via Dolce, Venice, CA 90292 | Professional Engineer | 2020-02-01 ~ 2021-01-31 |
| Clix, Inc. | 137 Reef Mall, Marina Del Rey, CA 90292 | Securities - Exemptions | 2019-07-29 ~ |
| Pamela Louise Reed | 13246 Mindanao Way, Marina Del Rey, CA 90292 | Registered Nurse | 2020-02-01 ~ 2021-01-31 |
| Gihan S Abdel Samed | 14021 Marquesas Way, Marina Del Rey, CA 90292 | Physician/surgeon | 2019-10-01 ~ 2020-09-30 |
| Agne Siauruseviciute | 13836 Bora Bora Way, Marina Del Rey, CA 90292 | Registered Nurse | 2019-08-01 ~ 2020-07-31 |
| Nicholas J Scarpati | 13701 Marina Pointe Dr Apt 129, Marina Del Rey, CA 90292 | Electrical Unlimited Journeyperson | 2019-10-01 ~ 2020-09-30 |
| Joanne C Moyer | 13935 W. Tahiti Way, Marina Del Ray, CA 90292 | Physical Therapist | 2011-01-01 ~ 2011-12-31 |
| Concerned Businessmen's Association of America | 13428 Maxella Ave, # 248, Marina Del Rey, CA 90292 | Public Charity | ~ |
| Advanced Structures Inc | 4094 Glencoe Ave, Marina Del Rey, CA 90292 | Professional Engineering Corporation | ~ |
| Geraldine Blake | 4077 Glencoe Ave, Marina Del Rey, CA 90292 | Registered Nurse | 2007-10-29 ~ 2008-10-31 |
| Find all Licenses in zip 90292 | |||
| City | Marina Del Rey |
| Zip Code | 90292 |
| License Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| License Type + County | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER + Marina Del Rey |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Keisha B Johnson Aprn | 40 Olga Ave, Windsor, CT 06095-4526 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Rhonda L Johnson Aprn | 100 Temple St Apt 12, New Haven, CT 06510-2711 | Controlled Substance Registration for Practitioner | 2011-03-01 ~ 2013-02-28 |
| Diana E Johnson Aprn | 2 Rachel Ln, Ivoryton, CT 06442-1154 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Dacia N Johnson Aprn | 40 Foster St, New Haven, CT 06511-2608 | Controlled Substance Registration for Practitioner | 2011-08-26 ~ 2013-02-28 |
| Elizabeth Ann Johnson Aprn | 27 Spring Street., Windsor, CT 06095 | Controlled Substance Registration for Practitioner | 2017-03-01 ~ 2019-02-28 |
| Ann Burzynski Aprn | Po Box 158, Colchester, VT 05446-0158 | Controlled Substance Registration for Practitioner | 2009-03-01 ~ 2011-02-28 |
| Jane F Moysak Aprn | 68 Rye Rd, Rye, NY 10580-2228 | Controlled Substance Registration for Practitioner | 2009-03-01 ~ 2011-02-28 |
| Philip G Ong | 267 Grant St, Bridgeport, CT 06610-2805 | Controlled Substance Registration for Practitioner | 2011-03-01 ~ 2013-02-28 |
| Philip A Frick | Po Box 719, Niantic, CT 06357-0719 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Philip Y Wai | 100 Temple St Apt 202, New Haven, CT 06510 | Controlled Substance Registration for Practitioner | 2006-03-28 ~ 2007-02-28 |
Please comment or provide details below to improve the information on PHILIP T JOHNSON APRN.
| 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).