LATISHA M GRAY PA (Credential# 993472) is licensed (Controlled Substance Registration for Practitioner) with Connecticut Department of Consumer Protection. The license effective date is March 1, 2017. The license expiration date date is February 28, 2019. The license status is LAPSED.
LATISHA M GRAY PA is licensed with the Department of Consumer Protection of Connecticut. The credential number is #CSP.0049980. The credential type is controlled substance registration for practitioner. The effective date is March 1, 2017. The expiration date is February 28, 2019. The business address is 72 Cogswell St, Bridgeport, CT 06610-1945. The current status is lapsed.
| Licensee Name | LATISHA M GRAY PA |
| Credential ID | 993472 |
| Credential Number | CSP.0049980 |
| Credential Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| Business Address |
72 Cogswell St Bridgeport CT 06610-1945 |
| Business Type | INDIVIDUAL |
| Status | LAPSED |
| Active | 1 |
| Issue Date | 2011-04-18 |
| Effective Date | 2017-03-01 |
| Expiration Date | 2019-02-28 |
| Refresh Date | 2019-03-06 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 982214 | 23.002538 | Physician Assistant | 2011-01-24 | 2017-08-01 - 2018-07-31 | INACTIVE |
| 818003 | 69.000580 | Emergency Medical Responder | 2000-06-27 | 2000-06-27 - 2002-04-01 | INACTIVE |
| Street Address | 72 COGSWELL ST |
| City | BRIDGEPORT |
| State | CT |
| Zip Code | 06610-1945 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Adenike Anjorin | 80 Cogswell St # 1, Bridgeport, CT 06610-1945 | Licensed Practical Nurse | ~ |
| Batjar Trendafili · Ervin Home Construction | 78 Cogswell St, Bridgeport, CT 06610-1945 | Home Improvement Contractor | 2012-02-14 ~ 2012-11-30 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Nilca Janice Cardenales | 66 Rose St, Bridgeport, CT 06610 | Combination Nail Technician, Esthetician Or Eyelash Technici | ~ |
| Kiara Lizbeth Corporan | 10 Sturtevant Pl, Bridgeport, CT 06610 | Eyelash Technician | ~ |
| Alisha Garcia | 65 Berkeley Place, Bridgeport, CT 06610 | Notary Public Appointment | 2020-06-26 ~ 2025-06-30 |
| Pauline Parkes | 96 Virginia Avenue, Bridgeport, CT 06610 | Licensed Clinical Social Worker | ~ |
| Denise Reyes | 1125 Huntington Turnpike, Bridgeport, CT 06610 | Registered Nurse | 2020-07-01 ~ 2021-06-30 |
| Avery M Rilley | 80 Granfield Avenue, Bridgeport, CT 06610 | Pharmacy Technician | 2020-06-25 ~ 2021-03-31 |
| Bozena K. Malyszko | Bridgeport Hospital, Bridgeport, CT 06610 | Physician/surgeon | 2020-07-01 ~ 2021-06-30 |
| Amy Espinosa | 146 Court D, Bridgeport, CT 06610 | Notary Public Appointment | 2020-07-01 ~ 2025-06-30 |
| Wilhelmina Jackson · Thomas | 172 Court D, Bridgeport, CT 06610 | Registered Nurse | 2020-08-01 ~ 2021-07-31 |
| Emma Agyeiwaa Vaczek | P.o Box 5223, Bridgeport, CT 06610 | Licensed Practical Nurse | 2020-08-01 ~ 2021-07-31 |
| Find all Licenses in zip 06610 | |||
| City | BRIDGEPORT |
| Zip Code | 06610 |
| License Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| License Type + County | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER + BRIDGEPORT |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Latisha M Pettway | 30 Austin Street, New Haven, CT 06515 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Jeffrey Gray Dmd | 155 Meadow St, Naugatuck, CT 06770 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Stephen R Gray | 7 Blackstone Ct, Danbury, CT 06811-3875 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| James P Gray | 64 Robbins St, Waterbury, CT 06708-2613 | Controlled Substance Registration for Practitioner | 2011-03-01 ~ 2013-02-28 |
| F Scott Gray | 33 Hospital Ave, Danbury, CT 06810-6007 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Robyn A Gray | 1 Wardrobe Rd, Hanover, NH 03755 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Jonathan Gray | Hospital of Raphael, New Haven, CT 06511 | Controlled Substance Registration for Practitioner | 2011-03-01 ~ 2013-02-28 |
| Peter A Gray Md | 72 Hidden Valley, Ctr Tuftonboro, NH 03816 | Controlled Substance Registration for Practitioner | 2003-03-01 ~ 2005-02-28 |
| Pamela E Gray Md | 14 Lakeview Terrace, Trumbull, CT 06611 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Kiesha N Benn | 4 Gray Pine Cmn, Avon, CT 06001 | Controlled Substance Registration for Practitioner | 2015-03-01 ~ 2017-02-28 |
Please comment or provide details below to improve the information on LATISHA M GRAY PA.
| 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).