JERALYN R FANTARELLA DMD (Credential# 702126) is licensed (Dentist) with Connecticut Department of Consumer Protection. The license effective date is March 1, 2020. The license expiration date date is February 28, 2021. The license status is ACTIVE.
JERALYN R FANTARELLA DMD is licensed with the Department of Consumer Protection of Connecticut. The credential number is #2.007613. The credential type is dentist. The effective date is March 1, 2020. The expiration date is February 28, 2021. The business address is 127 Washington Ave., North Haven, CT 06473. The current status is active.
| Licensee Name | JERALYN R FANTARELLA DMD |
| Credential ID | 702126 |
| Credential Number | 2.007613 |
| Credential Type | Dentist |
| Business Address |
127 Washington Ave. North Haven CT 06473 |
| Business Type | INDIVIDUAL |
| Status | ACTIVE - CURRENT |
| Active | 1 |
| Issue Date | 1990-07-14 |
| Effective Date | 2020-03-01 |
| Expiration Date | 2021-02-28 |
| Refresh Date | 2020-02-14 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 160077 | CSP.0018381 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 1999-06-21 | 2019-03-01 - 2021-02-28 | ACTIVE |
| Street Address | 127 Washington Ave. |
| City | North Haven |
| State | CT |
| Zip Code | 06473 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Slossberg, Sachs & Milone, LLC | 127 Washington Ave., North Haven, CT 06473 | Certified Public Accountant Firm Permit | 2004-01-01 ~ 2004-12-31 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Renee A Rollier | 90 Fallon Drive, North Haven, CT 06473 | Registered Nurse | 2020-07-01 ~ 2021-06-30 |
| Carly J Brueggestrat Aprn | 191 Cloudland Rd, North Haven, CT 06473 | Registered Nurse | 2020-08-01 ~ 2021-07-31 |
| Heesuk Hyun | 769 Middletown Ave, North Haven, CT 06473 | Combination Nail Technician, Esthetician Or Eyelash Technici | ~ |
| Jacqueline N Sancho | 9 Corey Rd, North Haven, CT 06473 | Physical Therapist Assistant | 2020-08-01 ~ 2021-07-31 |
| Irene L Smith | 35 Debra Lane, North Haven, CT 06473 | Radiographer | 2020-08-01 ~ 2021-07-31 |
| Jane S Jane | 380 Skiff Street, North Haven, CT 06473 | Psychologist | 2020-09-01 ~ 2021-08-31 |
| Shana Kathleen Lipp | [email protected], North Haven, CT 06473 | Combination Nail Technician, Esthetician Or Eyelash Technici | ~ |
| Haifeng Piao | 201 Universal Drive, North Haven, CT 06473 | Nail Technician | ~ |
| Xuefan Piao | 32 Lexington Gardens, North Haven, CT 06473 | Nail Technician | ~ |
| Zachary A Cuzzocreo | 45 Thorpe Street, North Haven, CT 06473 | Real Estate Salesperson | 2020-06-20 ~ 2021-05-31 |
| Find all Licenses in zip 06473 | |||
| City | North Haven |
| Zip Code | 06473 |
| License Type | Dentist |
| License Type + County | Dentist + North Haven |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Jeralyn R Keltonic | 87 Fog Plain Road, Waterford, CT 06385 | Registered Nurse | 2008-04-11 ~ 2009-05-31 |
| Jeralyn A Bernier | 3b Hamill Road, Baltimore, MD 21210 | Physician/surgeon | 1992-08-26 ~ 1993-07-31 |
| Jeralyn Renee Tefft | 230 Kingstown Rd, Richmond, RI 02898-1128 | Registered Nurse | 2020-06-01 ~ 2021-05-31 |
| Jeralyn Musser | 216 Broad St. 3rd Fl, New London, CT 06320 | Medication Administration Certification | 1991-03-29 ~ 1993-03-28 |
| Jeralyn J. Haber | 25 Poe Place, Shelton, CT 06484 | Certified Public Accountant License | 2020-01-01 ~ 2020-12-31 |
| Jeralyn S Burns | 66 Saint John St, North Haven, CT 06473-2315 | Real Estate Salesperson | 2020-06-01 ~ 2021-05-31 |
| Tyler D Fantarella | 39 Cedar Rd, Bethany, CT 06524-3340 | Emergency Medical Responder | ~ |
| Douglas L Fantarella | 84 Fountain St, New Haven, CT 06516 | Real Estate Salesperson | ~ |
| Laura Fantarella | 468 Fairway Rd, Orange, CT 06477 | Real Estate Salesperson | 2007-06-01 ~ 2008-05-31 |
| Brittany Fantarella | 172 Cedarmountain Rd, Thomaston, CT 06787 | Notary Public Appointment | 2018-06-14 ~ 2023-06-30 |
Please comment or provide details below to improve the information on JERALYN R FANTARELLA DMD.
| 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).