ERWIN PARK (Credential# 1176815) 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 INACTIVE.
ERWIN PARK is licensed with the Department of Consumer Protection of Connecticut. The credential number is #CSP.0055745. 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 25 Fairlee Road, West Hartford, CT 06107. The current status is inactive.
| Licensee Name | ERWIN PARK |
| Credential ID | 1176815 |
| Credential Number | CSP.0055745 |
| Credential Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| Business Address |
25 Fairlee Road West Hartford CT 06107 |
| Business Type | INDIVIDUAL |
| Status | INACTIVE - LACK OF ACTIVE MEDICAL LICENSE |
| Issue Date | 2013-08-05 |
| Effective Date | 2019-03-01 |
| Expiration Date | 2021-02-28 |
| Refresh Date | 2020-04-22 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 1488179 | 2.012056-RES | Resident Dentist | 2013-07-01 | 2013-07-01 - 2019-06-30 | INACTIVE |
| 1177184 | CSP.0055787 | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER | 2013-08-06 | 2013-08-06 - 2015-02-28 | INACTIVE |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Erwin Park | 25 Fairlee Rd, West Hartford, CT 06107-2908 | Dentist | 2018-06-04 ~ 2019-04-30 |
| Street Address | 25 Fairlee Road |
| City | West Hartford |
| State | CT |
| Zip Code | 06107 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Thomas H Ahearn | 25 Fairlee Road, West Hartford, CT 06100 | Notary Public Appointment | 1962-12-01 ~ 1967-03-31 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Rebecca L Stansfield | 73 Tunxis Road, West Hartford, CT 06107 | Registered Nurse | 2020-09-01 ~ 2021-08-31 |
| Kumari Joshi | 44 Bentwood Rd, West Hartford, CT 06107 | Combination Nail Technician, Esthetician Or Eyelash Technici | ~ |
| Laurie C Caines Md | 205 Stoner Drive, West Hartford, CT 06107 | Physician/surgeon | 2020-07-01 ~ 2021-06-30 |
| Nicole K. Edlund | 11 Greenacres Avenue, West Hartford, CT 06107 | Master's Level Social Worker - Temporary Permit | ~ |
| Andrea M Yuliano | 39 Mountain Terrace Road, West Hartford, CT 06107 | Registered Nurse | 2020-07-01 ~ 2021-06-30 |
| Elizabeth M Ineson | 4 Linwold Dr, West Htfd, CT 06107 | Architect | 2020-08-01 ~ 2021-07-31 |
| Sarah G Potter | 19 Westland Ave, West Hartford, CT 06107 | Registered Nurse | 2020-09-01 ~ 2021-08-31 |
| Jessica C Abreu | 14 Deepwood Lane, West Hartford, CT 06107 | Real Estate Salesperson | 2020-06-18 ~ 2021-05-31 |
| William C Richter | 67 Hillsboro Drive, West Hartford, CT 06107 | Architect | 2020-08-01 ~ 2021-07-31 |
| Teresa M Stanton | 25 Common Dr., West Hartford, CT 06107 | Registered Nurse | 2020-07-01 ~ 2021-06-30 |
| Find all Licenses in zip 06107 | |||
| City | West Hartford |
| Zip Code | 06107 |
| License Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| License Type + County | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER + West Hartford |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Erwin H Bernbach Dpm | 171 Grandview Ave, Waterbury, CT 06708 | Controlled Substance Registration for Practitioner | 2006-03-01 ~ 2007-02-28 |
| Terri Erwin Md | 15 Berger Place, Branford, CT 06405 | Controlled Substance Registration for Practitioner | 2003-03-03 ~ 2004-02-28 |
| Mark David Friedland | 2610 Erwin Rd Unit 318, Durham, NC 27705 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Meyeon Park | 246 Park Street Apartment 23, New Haven, CT 06511 | Controlled Substance Registration for Practitioner | 2008-03-01 ~ 2009-02-28 |
| Michael Minchul Park | 226 Orchard Park, Allendale, NJ 07401-1746 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| John J Khadem Md | 3003 New Hydg Park Suite 311, New Hyde Park, NY 11040 | Controlled Substance Registration for Practitioner | 2001-03-01 ~ 2002-02-28 |
| Fred Joseph De Lucia | 3003 New Hyde Park Rd Ste 312, New Hyde Park, NY 11042-1214 | Controlled Substance Registration for Practitioner | 2019-09-10 ~ 2021-02-28 |
| Sai Mi Kim | 456 Park St, Hartford, CT 06106-1525 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Neha Lad | 111 Park St Apt 9c, New Haven, CT 06511-5432 | Controlled Substance Registration for Practitioner | 2015-03-01 ~ 2017-02-28 |
| Pit Keung P Lai | 14 Park Pl, Hartford, CT 06106-5005 | Controlled Substance Registration for Practitioner | 2019-05-23 ~ 2021-02-28 |
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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).