MARY A WALLER
Registered Nurse


Address: 1 West Cotton Hl Rd, Portland, CT 06480

MARY A WALLER (Credential# 595458) is licensed (Registered Nurse) with Connecticut Department of Consumer Protection. The license effective date is November 8, 1999. The license expiration date date is October 31, 2000. The license status is INACTIVE.

Business Overview

MARY A WALLER is licensed with the Department of Consumer Protection of Connecticut. The credential number is #10.E17729. The credential type is registered nurse. The effective date is November 8, 1999. The expiration date is October 31, 2000. The business address is 1 West Cotton Hl Rd, Portland, CT 06480. The current status is inactive.

Basic Information

Licensee Name MARY A WALLER
Credential ID 595458
Credential Number 10.E17729
Credential Type Registered Nurse
Business Address 1 West Cotton Hl Rd
Portland
CT 06480
Business Type INDIVIDUAL
Status INACTIVE - LAPSED DUE TO NON-RENEWAL
Issue Date 1950-03-15
Effective Date 1999-11-08
Expiration Date 2000-10-31
Refresh Date 2009-07-08

Office Location

Street Address 1 WEST COTTON HL RD
City PORTLAND
State CT
Zip Code 06480

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Amanda R. Weinberger 270 Main St. Suite A, Portland, CT 06480 Advanced Practice Registered Nurse 2020-08-01 ~ 2021-07-31
Karen L Cianci 3 Myrtle Rd, Portland, CT 06480 Hairdresser/cosmetician 2020-07-01 ~ 2022-06-30
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Competitor

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City PORTLAND
Zip Code 06480
License Type Registered Nurse
License Type + County Registered Nurse + PORTLAND

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Rubye G Wilson 11 Waller Court, New London, CT 06320 Registered Nurse 2002-11-05 ~ 2003-12-31
Suzzanne Renwick 41 Waller Avenue, Wolcott, CT 06716 Registered Nurse 1995-03-03 ~ 1996-02-29
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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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