HEATHER R. GODALE (Credential# 1079970) is licensed (Controlled Substance Registration for Practitioner) with Connecticut Department of Consumer Protection. The license effective date is March 14, 2019. The license expiration date date is February 28, 2021. The license status is ACTIVE.
HEATHER R. GODALE is licensed with the Department of Consumer Protection of Connecticut. The credential number is #CSP.0052812. The credential type is controlled substance registration for practitioner. The effective date is March 14, 2019. The expiration date is February 28, 2021. The business address is Emergency Medicine Physicians, Canton, OH 44718. The current status is active.
| Licensee Name | HEATHER R. GODALE |
| Credential ID | 1079970 |
| Credential Number | CSP.0052812 |
| Credential Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| Business Address |
Emergency Medicine Physicians Canton OH 44718 |
| Business Type | INDIVIDUAL |
| Status | ACTIVE - CURRENT |
| Active | 1 |
| Issue Date | 2012-07-03 |
| Effective Date | 2019-03-14 |
| Expiration Date | 2021-02-28 |
| Refresh Date | 2019-03-15 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 1066592 | 1.050960 | Physician/Surgeon | 2012-05-24 | 2019-04-01 - 2020-03-31 | ACTIVE |
| Street Address | EMERGENCY MEDICINE PHYSICIANS |
| City | CANTON |
| State | OH |
| Zip Code | 44718 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Andrew J. Wagner | Emergency Medicine Physicians, Canton, OH 44718 | Physician/surgeon | 2019-12-01 ~ 2020-11-30 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Dominic J Bagnoli Jr. | 4535 Dressler Road N.w., Canton, OH 44718 | Physician/surgeon | 2020-03-01 ~ 2021-02-28 |
| Valerie J. De Maio | 4535 Dressler Road Nw, Canton, OH 44718 | Physician/surgeon | 2020-05-01 ~ 2021-04-30 |
| David C Packo | Emergency Medicine Physicans, Canton, OH 44718 | Physician/surgeon | 2018-02-01 ~ 2019-01-31 |
| Stephen J Sanofsky | 2930 Sussex Nw, Canton, OH 44718 | Physician/surgeon | 2013-10-01 ~ 2014-09-30 |
| Ghassan H Kabbara | 6615 Knightsbridge Ave Nw, Canton, OH 44718 | Professional Engineer | 2006-02-01 ~ 2007-01-31 |
| William D Morrison | 5958 Shakertown Dr, Canton, OH 44718 | Respiratory Care Practitioner | 1999-05-27 ~ 2000-05-31 |
| Monty R Reed | 5522 West Blvd Nw, Canton, OH 44718 | Professional Engineer | 2007-02-01 ~ 2008-01-31 |
| Jeremy D Tucker | 4535 Dressler Road Nw, Canton, OH 44718 | Physician/surgeon | 2020-04-01 ~ 2021-03-31 |
| Frank Skobel | 4535 Dressler Rd Nw, Canton, OH 44718-2545 | Physician/surgeon | 2020-07-01 ~ 2021-06-30 |
| Richard L Maenza | 4535 Dressler Rd Nw, Canton, OH 44718-2545 | Physician/surgeon | 2020-05-01 ~ 2021-04-30 |
| Find all Licenses in zip 44718 | |||
| City | CANTON |
| Zip Code | 44718 |
| License Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| License Type + County | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER + CANTON |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Heather A Alfonso | 195 Joy Rd, Middlebury, CT 06762-2521 | Controlled Substance Registration for Practitioner | 2015-03-01 ~ 2017-02-28 |
| Heather L Phillips | 35 Westwood Cir, Meriden, CT 06450-7253 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Heather O Tory | 282 Washington St, Hartford, CT 06106-3322 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Heather S Applewhite | 129 Woodland St Apt 44, Hartford, CT 06105-1218 | Controlled Substance Registration for Practitioner | 2014-07-09 ~ 2015-02-28 |
| Heather Hooper Pa | 729 Quinnipiac Ave, New Haven, CT 06513 | Controlled Substance Registration for Practitioner | 1995-01-25 ~ 1996-02-28 |
| Heather A Schlott Md | 282 Washington St, Hartford, CT 06106-3322 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Heather Harris | 19 Galaxy Dr, Manchester, CT 06040-6304 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Heather M Bradford | 17 Sterling St Fl 2, Hartford, CT 06112-2354 | Controlled Substance Registration for Practitioner | 2015-03-01 ~ 2017-02-28 |
| Heather Humphrey | 84 Portland St, Oakville, CT 06779-1032 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Heather W Myrick | 55 Pebble Dr, Southington, CT 06489-1751 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
Please comment or provide details below to improve the information on HEATHER R. GODALE.
| 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).