BROOKE F HENDERSON PA-C (Credential# 1029000) 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.
BROOKE F HENDERSON PA-C is licensed with the Department of Consumer Protection of Connecticut. The credential number is #CSP.0051225. 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 24 Ash Dr, Gales Ferry, CT 06335-1702. The current status is active.
| Licensee Name | BROOKE F HENDERSON PA-C |
| Credential ID | 1029000 |
| Credential Number | CSP.0051225 |
| Credential Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| Business Address |
24 Ash Dr Gales Ferry CT 06335-1702 |
| Business Type | INDIVIDUAL |
| Status | ACTIVE - CURRENT |
| Active | 1 |
| Issue Date | 2011-08-17 |
| Effective Date | 2019-03-01 |
| Expiration Date | 2021-02-28 |
| Refresh Date | 2018-12-28 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 1004550 | 23.002597 | Physician Assistant | 2011-07-18 | 2020-01-01 - 2020-12-31 | ACTIVE |
| 848797 | 70.009064 | Emergency Medical Technician | 2007-12-11 | 2007-12-11 - 2009-10-01 | INACTIVE |
| Street Address | 24 ASH DR |
| City | GALES FERRY |
| State | CT |
| Zip Code | 06335-1702 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Sally M Derusha · Mccrea | 8 Brewster Drive, Gales Ferry, CT 06335 | Hairdresser/cosmetician | 2020-07-01 ~ 2022-06-30 |
| Melissa A Kearney · Seidel | 853 Long Cove Rd, Gales Ferry, CT 06335 | Radiographer | 2020-07-01 ~ 2021-06-30 |
| Thomas Mcgarry | 1649 Ct-12, Gales Ferry, CT 06335 | Cross Connection Survey Inspector | 2020-03-05 ~ 2022-12-31 |
| Barbara J Smith | 5 Woodridge Circle, Gales Ferry, CT 06335 | Notary Public Appointment | 2020-09-01 ~ 2025-08-31 |
| Mary E Hurley | 8 Cornell Court, Gales Ferry, CT 06335 | Registered Nurse | 2020-08-01 ~ 2021-07-31 |
| Ann Marie Hanson Aprn | 31 Washington Drive, Gales Ferry, CT 06335 | Registered Nurse | 2020-07-01 ~ 2021-06-30 |
| Dunkin Donuts #331844 · J J M A Donuts LLC | 1662 Route 12, Gales Ferry, CT 06335 | Bakery | 2020-07-01 ~ 2021-06-30 |
| Mcdonalds | 1678 Rte 12, Gales Ferry, CT 06335 | Bakery | 2020-07-01 ~ 2021-06-30 |
| Carol A Collette | 2 Stonybrook Rd, Gales Ferry, CT 06335 | Registered Nurse | 2020-08-01 ~ 2021-07-31 |
| Reginald L Weed · R L Weed Company | 52a Vinegar Hill Rd, Gales Ferry, CT 06335 | Sub-surface Sewage Installer | 2020-08-01 ~ 2021-07-31 |
| Find all Licenses in zip 06335 | |||
| City | GALES FERRY |
| Zip Code | 06335 |
| License Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| License Type + County | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER + GALES FERRY |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Brooke E Albright | 900 Chapel St Apt 221, New Haven, CT 06510-2818 | Controlled Substance Registration for Practitioner | 2011-03-24 ~ 2013-02-28 |
| Brooke E Gouveia | 208 Newridge Ave, Waterbury, CT 06708 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Brooke K Sabia | 2090 Stanley St Apt 411, New Britain, CT 06053-1546 | Controlled Substance Registration for Practitioner | 2017-08-10 ~ 2019-02-28 |
| Brooke M Giddings Pac | 259 Oakville Avenue, Waterbury, CT 06708 | Controlled Substance Registration for Practitioner | 1999-04-13 ~ 2000-02-28 |
| Sarah Brooke Fleisig | 491 Main St, Westport, CT 06880-2159 | Controlled Substance Registration for Practitioner | 2017-07-19 ~ 2019-02-28 |
| Brooke E Fleit Aprn | 14 Stonewall Way, Durham, NH 03824-4410 | Controlled Substance Registration for Practitioner | 2013-03-01 ~ 2015-02-28 |
| Raymond L. So | 61 Towne Brooke Cmns, Brookfield, CT 06804-2557 | Controlled Substance Registration for Practitioner | 2011-03-18 ~ 2013-02-28 |
| Brooke Laura Duffany | 25 Avalon Ave, Oakville, CT 06779-2001 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Brooke L Davidson Do | 10 Lillinonah Ridge Dr, New Milford, CT 06776-4683 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Katlin Brooke Povich | 750 Quinnipiac Ave Apt 3, New Haven, CT 06513-3367 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
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| 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).