PHILIP L FAVA II (Credential# 944208) is licensed (Controlled Substance Registration for Practitioner) with Connecticut Department of Consumer Protection. The license effective date is March 1, 2013. The license expiration date date is February 28, 2015. The license status is INACTIVE.
PHILIP L FAVA II is licensed with the Department of Consumer Protection of Connecticut. The credential number is #CSP.0048079. The credential type is controlled substance registration for practitioner. The effective date is March 1, 2013. The expiration date is February 28, 2015. The business address is 222 Castlewood Dr, Bloomfield, CT 06002-1370. The current status is inactive.
| Licensee Name | PHILIP L FAVA II |
| Credential ID | 944208 |
| Credential Number | CSP.0048079 |
| Credential Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| Business Address |
222 Castlewood Dr Bloomfield CT 06002-1370 |
| Business Type | INDIVIDUAL |
| Status | INACTIVE |
| Issue Date | 2010-07-22 |
| Effective Date | 2013-03-01 |
| Expiration Date | 2015-02-28 |
| Refresh Date | 2016-01-29 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 936264 | 2.010312 | Dentist | 2010-07-15 | 2012-07-01 - 2013-06-30 | INACTIVE |
| Street Address | 222 CASTLEWOOD DR |
| City | BLOOMFIELD |
| State | CT |
| Zip Code | 06002-1370 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Jennifer A Libassi | 284 Castlewood Dr, Bloomfield, CT 06002-1370 | Licensed Practical Nurse | 2020-09-01 ~ 2021-08-31 |
| Bryan Lane | 262 Castlewood Dr, Bloomfield, CT 06002-1370 | Certified Public Accountant License | 2020-01-01 ~ 2020-12-31 |
| David M Hovey | 286 Castlewood Dr, Bloomfield, CT 06002-1370 | Professional Counselor | 2019-12-01 ~ 2020-11-30 |
| Gordon S Mathews | 268 Castlewood Dr, Bloomfield, CT 06002-1370 | Pharmacy Technician | 2017-04-01 ~ 2018-03-31 |
| Matthew T Redman | 202 Castlewood Dr, Bloomfield, CT 06002-1370 | Wholesaler Salesman | 2017-02-01 ~ 2019-01-31 |
| Mary A Calvert-heavilin | 206 Castlewood Dr, Bloomfield, CT 06002-1370 | Licensed Clinical Social Worker | 2011-07-01 ~ 2012-06-30 |
| Lana Burchman | 288 Castlewood Dr, Bloomfield, CT 06002-1370 | Registered Nurse | 2010-02-01 ~ 2011-01-31 |
| Robert A Heavilin | 206 Castlewood Dr, Bloomfield, CT 06002-1370 | Psychologist | 2004-12-03 ~ 2006-01-31 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Paula L Raines | 92 Daniel Blvd, Bloomfield, CT 06002 | Licensed Practical Nurse | 2020-07-01 ~ 2021-06-30 |
| Kesone Taletia Telfer | 36 Walsh Street, Bloomfield, CT 06002 | Advanced Practice Registered Nurse | ~ |
| Joan Zito Upton | 106 Duncaster Road, Bloomfield, CT 06002 | Dental Hygienist | 2020-08-01 ~ 2021-07-31 |
| Sheri M Sparks | Primary Eye Care Center, Bloomfield, CT 06002 | Optometrist | 2020-09-01 ~ 2021-08-31 |
| Kaman Aerospace Corporation | Old Windsor Road, Bloomfield, CT 06002 | Operator of Weighing & Measuring Devices | 2020-08-01 ~ 2021-07-31 |
| Healing Meals Foundation Corporation | Po Box 7223, Bloomfield, CT 06002 | Public Charity | 2020-12-01 ~ 2021-11-30 |
| Taylor A West | 5 Tiffany Ln, Bloomfield, CT 06002 | Registered Nurse | 2020-07-01 ~ 2021-06-30 |
| Emma J Ranel | 53 Burr Road, Bloomfield, CT 06002 | Licensed Practical Nurse | 2020-07-01 ~ 2021-06-30 |
| Dorothy W Field | 177 Oliver Way, Bloomfield, CT 06002 | Registered Nurse | 2020-09-01 ~ 2021-08-31 |
| Carol J Mortensen | 6 Maple Edge Dr, Bloomfield, CT 06002 | Registered Nurse | 2020-07-01 ~ 2021-06-30 |
| Find all Licenses in zip 06002 | |||
| City | BLOOMFIELD |
| Zip Code | 06002 |
| License Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| License Type + County | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER + BLOOMFIELD |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Lou Fava & Son | 25 Pond Valley Rd, Woodbury, CT 06798 | Home Improvement Contractor | 1998-12-01 ~ 1999-11-30 |
| Philip Y Wai | 100 Temple St Apt 202, New Haven, CT 06510 | Controlled Substance Registration for Practitioner | 2006-03-28 ~ 2007-02-28 |
| 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 T Korthuis Md | 896 Quinnipiac Ave #7, New Haven, CT 06513 | Controlled Substance Registration for Practitioner | 1999-03-01 ~ 2000-02-28 |
| Philip J Mcwhorter Md | 5 Perryridge Rd., Greenwich, CT 06830 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Philip Yi Kit Pang | 20 York St, New Haven, CT 06510-3220 | Controlled Substance Registration for Practitioner | ~ |
| Philip M Falcone | 46 Prince St Ste 203, New Haven, CT 06519-1600 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Philip R Corvo Md | 133 Scoville St Ste 308, Waterbury, CT 06706-1127 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Philip R Pinter | 278 Vernon St, Manchester, CT 06042-3418 | Controlled Substance Registration for Practitioner | 2019-12-03 ~ 2021-02-28 |
Please comment or provide details below to improve the information on PHILIP L FAVA II.
| 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).