KELLY N WASHBURN (Credential# 1132155) is licensed (Controlled Substance Registration for Practitioner) with Connecticut Department of Consumer Protection. The license effective date is April 9, 2019. The license expiration date date is February 28, 2021. The license status is ACTIVE.
KELLY N WASHBURN is licensed with the Department of Consumer Protection of Connecticut. The credential number is #CSP.0053991. The credential type is controlled substance registration for practitioner. The effective date is April 9, 2019. The expiration date is February 28, 2021. The business address is 2639 N Watts St, Portland, OR 97217-6369. The current status is active.
| Licensee Name | KELLY N WASHBURN |
| Credential ID | 1132155 |
| Credential Number | CSP.0053991 |
| Credential Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| Business Address |
2639 N Watts St Portland OR 97217-6369 |
| Business Type | INDIVIDUAL |
| Status | ACTIVE - CURRENT |
| Active | 1 |
| Issue Date | 2012-11-21 |
| Effective Date | 2019-04-09 |
| Expiration Date | 2021-02-28 |
| Refresh Date | 2019-04-11 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 1120263 | 12.005118 | Advanced Practice Registered Nurse | 2012-08-31 | 2019-11-01 - 2020-10-31 | ACTIVE |
| 981288 | 10.098624 | Registered Nurse | 2011-03-09 | 2019-11-01 - 2020-10-31 | ACTIVE |
| Street Address | 2639 N WATTS ST |
| City | PORTLAND |
| State | OR |
| Zip Code | 97217-6369 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Allied Med Wholesale Drug Co | 2519 N Hayden Island Dr, Portland, OR 97217 | Wholesaler of Drugs, Cosmetics & Medical Devices | 2002-12-27 ~ 2003-06-30 |
| Market Transport Ltd · Dsv Road Transport | 110 N Marine Dr, Portland, OR 97217 | Transporter Liquor | 2016-11-02 ~ 2017-11-01 |
| Market Transport Ltd | 110 N Marine Drive, Portland, OR 97217 | Transporter Liquor | 2013-08-09 ~ 2014-08-08 |
| Deanna T Liscio | 827 N Bryant, Portland, OR 97217 | Registered Nurse | 1996-10-15 ~ 1997-11-30 |
| Annette Costas | 11919 N Jantzen Ave, Portland, OR 97217 | Hairdresser/cosmetician | 1996-04-10 ~ 1997-03-31 |
| Jad M Mourad | 4708 N Haight Ave, Portland, OR 97217-2817 | Dentist | 2020-05-01 ~ 2021-05-31 |
| Julie M Greenough | 4316 N Albina Ave Apt A, Portland, OR 97217-3080 | Hairdresser/cosmetician | 2011-05-01 ~ 2013-04-30 |
| Eva Christina Lazarus | 2525 N Killingsworth St Apt 202, Portland, OR 97217-4470 | Registered Nurse | 2011-05-04 ~ 2012-05-31 |
| Joseph F Payne | 6856 N Atlantic Ave, Portland, OR 97217-5202 | Professional Engineer | 2015-02-01 ~ 2016-01-31 |
| Mary E Langhorst | 7036 N Burrage Ave, Portland, OR 97217-5220 | Registered Nurse | 2011-04-01 ~ 2012-03-31 |
| Find all Licenses in zip 97217 | |||
| City | PORTLAND |
| Zip Code | 97217 |
| License Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| License Type + County | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER + PORTLAND |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Abigail E Washburn Pa-c | 25 New South St #301, Northampton, MA 01060 | Controlled Substance Registration for Practitioner | 2008-03-01 ~ 2009-02-28 |
| Jennifer Washburn | 142 Natick Ave, Warwick, RI 02886-3157 | Controlled Substance Registration for Practitioner | 2019-02-05 ~ 2021-02-28 |
| Ravi M Kagali | 2 Washburn Ter Apt 2b, Saugerties, NY 12477 | Controlled Substance Registration for Practitioner | 2015-03-01 ~ 2017-02-28 |
| Heather L Washburn | 160 Cross Creek Way, Palmyra, VA 22963-4913 | Controlled Substance Registration for Practitioner | 2017-03-01 ~ 2019-02-28 |
| Christie C Marcus | 25 Washburn Drive, Stratford, CT 06614-4635 | Controlled Substance Registration for Practitioner | 2019-12-12 ~ 2021-02-28 |
| Carl F Washburn Jr Md | 281 Parish Hill Road, Chaplin, CT 06235 | Controlled Substance Registration for Practitioner | 2013-03-01 ~ 2015-02-28 |
| Kelly J Way | 34 B Springbrook Rd, Westerly, RI 02891 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Kelly M Deforest | 267 Rte 87, Columbia, CT 06237 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Kelly M. Doran Md | New Haven, CT 06511 | Controlled Substance Registration for Practitioner | 2013-03-01 ~ 2015-02-28 |
| Kelly Gullotta | Po Box 465, Brownsville, VT 05037-0465 | Controlled Substance Registration for Practitioner | 2020-04-09 ~ 2021-02-28 |
Please comment or provide details below to improve the information on KELLY N WASHBURN.
| 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).