STEPHANIE M MALIA (Credential# 1036420) 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.
STEPHANIE M MALIA is licensed with the Department of Consumer Protection of Connecticut. The credential number is #CSP.0051519. 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 319 Main St, Manchester, CT 06040-4128. The current status is active.
| Licensee Name | STEPHANIE M MALIA |
| Credential ID | 1036420 |
| Credential Number | CSP.0051519 |
| Credential Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| Business Address |
319 Main St Manchester CT 06040-4128 |
| Business Type | INDIVIDUAL |
| Status | ACTIVE - CURRENT |
| Active | 1 |
| Issue Date | 2011-10-07 |
| Effective Date | 2019-03-01 |
| Expiration Date | 2021-02-28 |
| Refresh Date | 2019-01-18 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 1027414 | 12.004778 | Advanced Practice Registered Nurse | 2011-09-01 | 2019-10-01 - 2020-09-30 | ACTIVE |
| 577882 | 10.073878 | Registered Nurse | 2004-07-30 | 2019-10-01 - 2020-09-30 | ACTIVE |
| Street Address | 319 MAIN ST |
| City | MANCHESTER |
| State | CT |
| Zip Code | 06040-4128 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Planned Parenthood of Southern New England | 319 Main St, Manchester, CT 06042-2007 | Family Planning | 2017-10-01 ~ 2021-09-30 |
| Manchester Dialysis Clinic | 319 Main St, Manchester, CT 06040-4128 | Hemodialysis | 2019-07-01 ~ 2021-06-30 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Kentucky Fried Chicken | 307 Main St, Manchester, CT 06040-4128 | Bakery | 2020-07-01 ~ 2021-06-30 |
| Walgreens #05407 | 295 Main St, Manchester, CT 06040-4128 | Retail Dairy Store | 2019-07-01 ~ 2021-06-30 |
| Allison C Lee | 295 Main St, Manchester, CT 06040-4128 | Pharmacy Technician | 2015-02-17 ~ 2016-03-31 |
| Walgreens #5407 | 295 Main St, Manchester, CT 06040-4128 | Operator of Weighing & Measuring Devices | 2008-07-24 ~ 2009-07-31 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Mary Fosuah Nketia | 61 Cougar Drive, Manchester, CT 06040 | Registered Nurse | 2020-08-01 ~ 2021-07-31 |
| New Seasons Inc. | 164 East Center Street, Manchester, CT 06040 | Public Charity | 2019-06-01 ~ 2020-05-31 |
| Kaylen Lam | 60 Chlistone Lane, Manchester, CT 06040 | Combination Nail Technician, Esthetician Or Eyelash Technici | ~ |
| Matilde Altamirano | 415 Gardner Street, Manchester, CT 06040 | Nail Technician | 2020-06-27 ~ 2022-04-30 |
| Meilan Meilan Chen | 174 Middle Tpke, Manchester, CT 06040 | Nail Technician | ~ |
| Prince Acheampong | 32 Bigelow Street, Manchester, CT 06040 | Notary Public Appointment | ~ |
| Erin C Boyle | 470 Porter Street, Manchester, CT 06040 | Registered Nurse | 2020-07-01 ~ 2021-06-30 |
| Dejone Mitchell | 64 Ruby Dr Apt. P, Manchester, CT 06040 | Combination Nail Technician, Esthetician Or Eyelash Technici | ~ |
| Andrea H Clifford | 116 Longview Drive, Manchester, CT 06040 | Licensed Practical Nurse | 2020-09-01 ~ 2021-08-31 |
| Tabia Thornton-bey | 103 Walek Farms Road, Manchester, CT 06040 | Licensed Clinical Social Worker | 2020-07-01 ~ 2021-06-30 |
| Find all Licenses in zip 06040 | |||
| City | MANCHESTER |
| Zip Code | 06040 |
| License Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| License Type + County | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER + MANCHESTER |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Laurie A Malia | 3050 Corlear Ave Apt 302, Bronx, NY 10463-5182 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Malia Mccarthy Md | 2902 Concord Ave, Davis, CA 95616 | Controlled Substance Registration for Practitioner | 2002-04-11 ~ 2003-02-28 |
| Chrystal L Malia | 20 York Street, New Haven, CT 06510 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Stephanie M Chu Do | 99 Woodland St, Hartford, CT 06105 | Controlled Substance Registration for Practitioner | 2008-03-20 ~ 2009-02-28 |
| Stephanie M Yang | 771 Mix Ave # D, Hamden, CT 06514 | Controlled Substance Registration for Practitioner | 2015-03-01 ~ 2017-02-28 |
| Stephanie T Borey Od | P. O. Box 6, Ledyard, CT 06339 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Stephanie Kramer | 13 Timmins Rd, Bow, NH 03304-4208 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Stephanie Zhu | 100 Evergreen Dr, Stratford, CT 06614-4431 | Controlled Substance Registration for Practitioner | 2020-05-29 ~ 2021-02-28 |
| Stephanie C Miller | 21 East Ct, Derby, CT 06418-2640 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Stephanie M Decesare | 6 Millbrook Rd, Shelton, CT 06484-1905 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
Please comment or provide details below to improve the information on STEPHANIE M MALIA.
| 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).