KEVIN MARTIN PA (Credential# 1006068) 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.
KEVIN MARTIN PA is licensed with the Department of Consumer Protection of Connecticut. The credential number is #CSP.0050658. 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 31 Kimberly Ln, Wethersfield, CT 06109-3994. The current status is active.
| Licensee Name | KEVIN MARTIN PA |
| Credential ID | 1006068 |
| Credential Number | CSP.0050658 |
| Credential Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| Business Address |
31 Kimberly Ln Wethersfield CT 06109-3994 |
| Business Type | INDIVIDUAL |
| Status | ACTIVE - CURRENT |
| Active | 1 |
| Issue Date | 2011-07-18 |
| Effective Date | 2019-03-01 |
| Expiration Date | 2021-02-28 |
| Refresh Date | 2019-01-09 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 996649 | 23.002579 | Physician Assistant | 2011-05-23 | 2020-01-01 - 2020-12-31 | ACTIVE |
| Street Address | 31 KIMBERLY LN |
| City | WETHERSFIELD |
| State | CT |
| Zip Code | 06109-3994 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Susan E Dimauro | 330 Ridge Rd, Wethersfield, CT 06109 | Registered Nurse | 2020-07-01 ~ 2021-06-30 |
| Mary Boccacio | 174 Longvue Drive, Wethersfield, CT 06109 | Esthetician | ~ |
| Steven C Hine | 294 Hang Dog Ln, Wethersfield, CT 06109 | Architect | 2020-08-01 ~ 2021-07-31 |
| Karolina Monika Fitrzyk | 41 Mountain Laurel, Wethersfield, CT 06109 | Combination Nail Technician, Esthetician Or Eyelash Technici | ~ |
| Matthew R Dobos | 33 Oxford St, Wethersfield, CT 06109 | Registered Nurse | 2020-07-01 ~ 2021-06-30 |
| Samantha Grabbe | 17 Rockland St, Wethersfield, CT 06109 | Registered Nurse | 2020-08-01 ~ 2021-07-31 |
| Judith M Martz | 307 Nott Street, Wethersfield, CT 06109 | Licensed Practical Nurse | 2020-07-01 ~ 2021-06-30 |
| Ups Store (the) | 1077 Silas Deane Hwy, Wethersfield, CT 06109 | Operator of Weighing & Measuring Devices | 2020-08-01 ~ 2021-07-31 |
| Amber H Washington | 103 Parkview Drive, Wethersfield, CT 06109 | Hairdresser/cosmetician | 2020-09-01 ~ 2022-08-31 |
| Kathleen A Mullady · Brancati | 75 Dale Rd, Wethersfield, CT 06109 | Registered Nurse | 2020-07-01 ~ 2021-06-30 |
| Find all Licenses in zip 06109 | |||
| City | WETHERSFIELD |
| Zip Code | 06109 |
| License Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| License Type + County | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER + WETHERSFIELD |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Kevin J Twohig | Kevin J Twohig Md, North Haven, CT 06473 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Kevin K Lee | 20 York St Tmp 209, New Haven, CT 06510-3220 | Controlled Substance Registration for Practitioner | 2013-03-01 ~ 2015-02-28 |
| Craig M Martin | 127 Balsam Dr, Waynesville, NC 28786-4301 | Controlled Substance Registration for Practitioner | 2011-03-01 ~ 2013-02-28 |
| Martin B Cohen Md | 19 Bradhurst Ave Ste 700, Hawthorne, NY 10532 | Controlled Substance Registration for Practitioner | 2011-03-01 ~ 2013-02-28 |
| Martin H Gad | 784 East Main St, Branford, CT 06405 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Jacqueline C Martin | 26 Chamberlain Hwy, Kensington, CT 06037-1921 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Gregory Martin Md | 140 Washington St, Vernon, CT 06066 | Controlled Substance Registration for Practitioner | 1992-12-29 ~ 1995-01-01 |
| Martin J Vogel | 297 George St Apt 7c, New Haven, CT 06511-6646 | Controlled Substance Registration for Practitioner | 2009-10-20 ~ 2011-02-28 |
| Andrew J Martin | 395 Elm St, West Springfield, MA 01089-2657 | Controlled Substance Registration for Practitioner | 2014-12-10 ~ 2017-02-28 |
| Martin L Karno | 894 Ocean Ave, New London, CT 06320 | Controlled Substance Registration for Practitioner | 1993-11-12 ~ 1995-12-01 |
Please comment or provide details below to improve the information on KEVIN MARTIN 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).