LEAH G WALLACE (Credential# 1058766) 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.
LEAH G WALLACE is licensed with the Department of Consumer Protection of Connecticut. The credential number is #CSP.0052205. 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 10 Pattagansett Court, Niantic, CT 06357. The current status is active.
| Licensee Name | LEAH G WALLACE |
| Credential ID | 1058766 |
| Credential Number | CSP.0052205 |
| Credential Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| Business Address |
10 Pattagansett Court Niantic CT 06357 |
| Business Type | INDIVIDUAL |
| Status | ACTIVE - CURRENT |
| Active | 1 |
| Issue Date | 2012-04-05 |
| Effective Date | 2019-03-01 |
| Expiration Date | 2021-02-28 |
| Refresh Date | 2019-01-18 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 1050449 | 23.002731 | Physician Assistant | 2012-02-28 | 2019-10-01 - 2020-09-30 | ACTIVE |
| 843901 | 70.004168 | Emergency Medical Technician | 2003-10-08 | 2005-02-17 - 2007-03-31 | INACTIVE |
| Street Address | 10 PATTAGANSETT COURT |
| City | NIANTIC |
| State | CT |
| Zip Code | 06357 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Young Sun Kim | 265 Roxbury Rd, Niantic, CT 06357 | Nail Technician | ~ |
| Melissa B Bender | 9 Hoskins St, Niantic, CT 06357 | Veterinarian | 2020-07-01 ~ 2021-06-30 |
| Rachel Brennan | 8 Louise Drive, Niantic, CT 06357 | Registered Nurse | 2020-07-01 ~ 2021-06-30 |
| Tianhua Wang | 11 King Arthur Dr Unit 2h, Niantic, CT 06357 | Nail Technician | 2020-06-26 ~ 2022-02-28 |
| Maxwell V Nucci | 70 Smith St, Niantic, CT 06357 | Public Weigher | 2020-07-01 ~ 2021-06-30 |
| Virada Lackey | 22 Sunnie Side Drive, Niantic, CT 06357 | Real Estate Salesperson | ~ |
| Niantic Cinema Corp | 279 Main St, Niantic, CT 06357 | Operator of Weighing & Measuring Devices | 2020-08-01 ~ 2021-07-31 |
| Olivia M Blodgett | 30 Lake Ave, Niantic, CT 06357 | Registered Nurse | 2020-07-01 ~ 2021-06-30 |
| Katherine S Kleczkowski | P.o. Box 281, Niantic, CT 06357 | Licensed Practical Nurse | 2020-09-01 ~ 2021-08-31 |
| Robert W Cunningham | 9 South Rd., Niantic, CT 06357 | Distribution System Operator - Class II | 2020-04-01 ~ 2023-03-31 |
| Find all Licenses in zip 06357 | |||
| City | NIANTIC |
| Zip Code | 06357 |
| License Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| License Type + County | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER + NIANTIC |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Leah Sun Kim | 20 York St, New Haven, CT 06510-3220 | Controlled Substance Registration for Practitioner | 2019-06-05 ~ 2021-02-28 |
| Leah Kaye | Dept of Ob Gyn, Farmington, CT 06030-0001 | Controlled Substance Registration for Practitioner | 2017-03-01 ~ 2019-02-28 |
| Leah Wilson | 57 Commonwealth Ave Apt 10, Boston, MA 02116-2394 | Controlled Substance Registration for Practitioner | 2017-08-30 ~ 2019-02-28 |
| Leah Greenberger Dvm | 195 Railroad St, Belchertown, MA 01007 | Controlled Substance Registration for Practitioner | 2011-03-01 ~ 2013-02-28 |
| Leah Brown | 8 E Porter Rd, Ellington, CT 06029-2711 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Leah Schecter | 20 York St, New Haven, CT 06510-3220 | Controlled Substance Registration for Practitioner | 2019-06-05 ~ 2021-02-28 |
| Leah D Anderson | 3 Murthas Way, Granby, CT 06035 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Leah Gregorio | 95 Edgewood Way, New Haven, CT 06515 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Leah G Post Md | 290 Western Blvd, Glastonbury, CT 06033-1259 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Leah S Coutts | 243 Steele Rd Apt 427, West Hartford, CT 06117-1732 | Controlled Substance Registration for Practitioner | 2017-07-31 ~ 2019-02-28 |
Please comment or provide details below to improve the information on LEAH G WALLACE.
| 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).