JUSTIN PERSICO (Credential# 1052994) 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.
JUSTIN PERSICO is licensed with the Department of Consumer Protection of Connecticut. The credential number is #CSP.0052008. 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 5520 Park Ave, Trumbull, CT 06611-3463. The current status is active.
| Licensee Name | JUSTIN PERSICO |
| Credential ID | 1052994 |
| Credential Number | CSP.0052008 |
| Credential Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| Business Address |
5520 Park Ave Trumbull CT 06611-3463 |
| Business Type | INDIVIDUAL |
| Status | ACTIVE - CURRENT |
| Active | 1 |
| Issue Date | 2012-02-24 |
| Effective Date | 2019-03-01 |
| Expiration Date | 2021-02-28 |
| Refresh Date | 2019-01-22 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 1044174 | 1.050598 | Physician/Surgeon | 2012-02-07 | 2020-02-01 - 2021-01-31 | ACTIVE |
| Street Address | 5520 PARK AVE |
| City | TRUMBULL |
| State | CT |
| Zip Code | 06611-3463 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Dina Ferdman | 5520 Park Ave, Trumbull, CT 06611-3463 | Physician/surgeon | 2020-05-01 ~ 2021-04-30 |
| Radhika S Datar | 5520 Park Ave, Trumbull, CT 06611-3466 | Physician/surgeon | 2020-04-01 ~ 2021-03-31 |
| Smilow Cancer Hospital Trumbull Treatment Ctr | 5520 Park Ave, Trumbull, CT 06611-3463 | Controlled Substance Registration for Hospitals | 2019-03-01 ~ 2021-02-28 |
| Danielle Marie Bertoni | 5520 Park Ave, Trumbull, CT 06611 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Germano Guadagnoli Md | 5520 Park Ave, Trumbull, CT 06611 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Rui Zhang | 5520 Park Ave, Trumbull, CT 06611 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Pediatric Oncology Treatment Center | 5520 Park Ave, Trumbull, CT 06611-3463 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Jordan Marcou | 5520 Park Ave, Trumbull, MA 06611-3463 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Roxanne C Abder Md | 5520 Park Ave, Trumbull, CT 06611-3463 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Andrew S Kenler | 5520 Park Ave, Trumbull, CT 06611-3465 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Find all Licenses in the same address | |||
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Philip Simkovitz Md | 5520 Park Ave Ste Wp1-900, Trumbull, CT 06611-3463 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Ashley S Balestriere | 7 Sutton Place, Trumbull, CT 06611 | Registered Nurse | 2020-08-01 ~ 2021-07-31 |
| Filomena L Ferraro · Nicolia | 35 Skating Pond Rd, Trumbull, CT 06611 | Registered Nurse | 2020-09-01 ~ 2021-08-31 |
| Alexis Grace Shaub | 58 Chestnut Hill Road, Trumbull, CT 06611 | Physician Assistant | 2020-08-01 ~ 2021-07-31 |
| Maria Bivona | 5302 Main Street, Trumbull, CT 06611 | Notary Public Appointment | 2020-10-01 ~ 2025-09-30 |
| Gina M Gallo · Liquigli | 20 Red Maple Lane, Trumbull, CT 06611 | Hairdresser/cosmetician | 2020-09-01 ~ 2022-08-31 |
| Xuehuan Zhang | 31 Asbury Rd, Trumbull, CT 06611 | Combination Nail Technician, Esthetician Or Eyelash Technici | ~ |
| Antoinette D Senior | 38 Tanager Lane, Trumbull, CT 06611 | Registered Nurse | 2020-07-01 ~ 2021-06-30 |
| Solution Construction LLC | 3 Stonewall Lane, Trumbull, CT 06611 | New Home Construction Contractor | 2020-06-18 ~ 2021-09-30 |
| Gary T Sorge | 63 Limerick Road, Trumbull, CT 06611 | Landscape Architect | 2020-08-01 ~ 2021-07-31 |
| Melodie T Noga | 55 Moose Hill Road, Trumbull, CT 06611 | Real Estate Salesperson | 2020-06-19 ~ 2021-05-31 |
| Find all Licenses in zip 06611 | |||
| City | TRUMBULL |
| Zip Code | 06611 |
| License Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| License Type + County | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER + TRUMBULL |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Justin A Cross Md | Po Box 362, Kedrsavge, NH 03847 | Controlled Substance Registration for Practitioner | 1997-03-01 ~ 1998-02-28 |
| Justin J Cohen | 835 Mix Ave, Hamden, CT 06514 | Controlled Substance Registration for Practitioner | 2004-09-10 ~ 2006-02-28 |
| Justin R. Bloom | Po Box 806, East Windsor, CT 06088 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Justin M Cohen | 3 White Dr, Cedarhurst, NY 11516-2607 | Controlled Substance Registration for Practitioner | 2019-07-08 ~ 2021-02-28 |
| Justin Gauthier | 176 Shewville Rd, Mystic, CT 06355-1210 | Controlled Substance Registration for Practitioner | ~ |
| Justin Raanan | 75 Peterborough St Apt 710, Boston, MA 02215-4315 | Controlled Substance Registration for Practitioner | 2015-06-16 ~ 2017-02-28 |
| Justin D Caskey | 270 Main St., Portland, CT 06480 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Justin P Rowberry | 233 Magee Dr, Hamden, CT 06514-1311 | Controlled Substance Registration for Practitioner | 2013-03-01 ~ 2015-02-28 |
| Justin M Russo | 64 Addison Rd Apt 102, Glastonbury, CT 06033 | Controlled Substance Registration for Practitioner | 2011-03-01 ~ 2013-02-28 |
| Justin Varghese | 15 Seth Ln, Hicksville, NY 11801-6514 | Controlled Substance Registration for Practitioner | 2014-07-30 ~ 2015-02-28 |
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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).