POLIENTO R ICO JR (Credential# 1117968) is licensed (Registered Nurse - Temporary) with Connecticut Department of Consumer Protection. The license effective date is August 15, 2012. The license expiration date date is December 13, 2012. The license status is INACTIVE.
POLIENTO R ICO JR is licensed with the Department of Consumer Protection of Connecticut. The credential number is #10.107680-TEMP. The credential type is registered nurse - temporary. The effective date is August 15, 2012. The expiration date is December 13, 2012. The business address is 995 Howell Mountain Rd, Pope Valley, CA 94567-9450. The current status is inactive.
Licensee Name | POLIENTO R ICO JR |
Credential ID | 1117968 |
Credential Number | 10.107680-TEMP |
Credential Type | Registered Nurse - Temporary |
Credential SubCategory | TEMP |
Business Address |
995 Howell Mountain Rd Pope Valley CA 94567-9450 |
Business Type | INDIVIDUAL |
Status | INACTIVE - INACTIVE |
Issue Date | 2012-08-15 |
Effective Date | 2012-08-15 |
Expiration Date | 2012-12-13 |
Refresh Date | 2012-12-14 |
ID | Credential Code | Credential Type | Issue | Term | Status |
---|---|---|---|---|---|
1117562 | 10 | Registered Nurse | - | EXPIRED APPLICATION |
Street Address | 995 HOWELL MOUNTAIN RD |
City | POPE VALLEY |
State | CA |
Zip Code | 94567-9450 |
Licensee Name | Office Address | Credential | Effective / Expiration |
---|---|---|---|
Magnus LLC · Magnus | 1500 Snell Valley Rd, Pope Valley, CA 94567-9400 | Out of State Winery | 2013-08-17 ~ 2014-08-16 |
Kerry Juliano | 2709 Harness Dr, Pope Valley, CA 94567-9424 | Registered Nurse | 2020-04-08 ~ 2021-03-31 |
City | POPE VALLEY |
Zip Code | 94567 |
License Type | Registered Nurse - Temporary |
License Type + County | Registered Nurse - Temporary + POPE VALLEY |
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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).