NICOLE R GRAHAM (Credential# 1198593) is licensed (Controlled Substance Registration for Practitioner) with Connecticut Department of Consumer Protection. The license effective date is January 2, 2020. The license expiration date date is February 28, 2021. The license status is ACTIVE.
NICOLE R GRAHAM is licensed with the Department of Consumer Protection of Connecticut. The credential number is #CSP.0056492. The credential type is controlled substance registration for practitioner. The effective date is January 2, 2020. The expiration date is February 28, 2021. The business address is 6324 N Chatham Ave # 177, Kansas City, MO 64151-2473. The current status is active.
| Licensee Name | NICOLE R GRAHAM |
| Credential ID | 1198593 |
| Credential Number | CSP.0056492 |
| Credential Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| Business Address |
6324 N Chatham Ave # 177 Kansas City MO 64151-2473 |
| Business Type | INDIVIDUAL |
| Status | ACTIVE - CURRENT |
| Active | 1 |
| Issue Date | 2013-12-14 |
| Effective Date | 2020-01-02 |
| Expiration Date | 2021-02-28 |
| Refresh Date | 2020-01-02 |
| ID | Credential Code | Credential Type | Issue | Term | Status |
|---|---|---|---|---|---|
| 1175884 | 1.052448 | Physician/Surgeon | 2013-09-18 | 2020-01-01 - 2020-12-31 | ACTIVE |
| Street Address | 6324 N CHATHAM AVE # 177 |
| City | KANSAS CITY |
| State | MO |
| Zip Code | 64151-2473 |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Clay H Marcusen | 6022 N. Strathbury Ave., Kansas City, MO 64151 | Registered Nurse | 2009-04-17 ~ 2009-12-31 |
| Patricia A Desimone | 1911 Nw 79 Terrace, Kansas City, MO 64151 | Registered Nurse | 2004-10-27 ~ 2005-12-31 |
| Melanie L Tisdale | 7849 Nw Roanridge Road, Kansas City, MO 64151 | Registered Nurse | 2004-03-01 ~ 2004-08-31 |
| Sharon D Adair | 7731 Nw Roanridge Road, Apt. B, Kansas City, MO 64151 | Speech and Language Pathologist | 2001-01-22 ~ 2002-01-31 |
| Bane Gaiser | 7508 Nw Woody Creek Ln, Platte Woods, MO 64151-1526 | Architect | 2013-08-01 ~ 2014-07-31 |
| Ric E Smith | 6836 Nw Dawn Ln, Kansas City, MO 64151-1718 | Registered Nurse | 2013-03-01 ~ 2014-02-28 |
| Emily Dale Berry | 5703 N Ames Ave, Kansas City, MO 64151-2181 | Registered Nurse | ~ |
| Rms Healthcare Consulting Inc | 6504a Nw Prairie View Rd, Kansas City, MO 64151-2303 | Wholesaler of Drugs, Cosmetics & Medical Devices | 2020-07-01 ~ 2021-06-30 |
| Steven L Worley | 7846 N Dawn Ave, Kansas City, MO 64151-2409 | Professional Engineer | 2017-02-01 ~ 2018-01-31 |
| Madison Brooke Taylor | 6100 N Lenox Ave, Kansas City, MO 64151-2732 | Registered Nurse | 2019-10-01 ~ 2020-09-30 |
| Find all Licenses in zip 64151 | |||
| City | KANSAS CITY |
| Zip Code | 64151 |
| License Type | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER |
| License Type + County | CONTROLLED SUBSTANCE REGISTRATION FOR PRACTITIONER + KANSAS CITY |
| Licensee Name | Office Address | Credential | Effective / Expiration |
|---|---|---|---|
| Scott C Graham Md | 19 Frontier Rd, Cos Cob, CT 06807 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Meghan Graham | 106 Captains Way, Philadelphia, PA 19146 | Controlled Substance Registration for Practitioner | 2020-04-29 ~ 2021-02-28 |
| Timur T Graham Md | 24 Park Dr Apt 25f, Hartford, CT 06106 | Controlled Substance Registration for Practitioner | 2009-06-22 ~ 2011-02-28 |
| Elizabeth Ann L Graham Pa | 260 Willow St, Southport, CT 06890 | Controlled Substance Registration for Practitioner | 2008-03-01 ~ 2009-02-28 |
| Graham B Garber | 45 Greenwood Ave, Rumford, RI 02916 | Controlled Substance Registration for Practitioner | 2015-03-01 ~ 2017-02-28 |
| Graham M Grabowski | 20 York St Tmp 209, New Haven, CT 06510-3220 | Controlled Substance Registration for Practitioner | 2015-03-01 ~ 2017-02-28 |
| Jessica L Graham | 53 Cannon Drive, Amston, CT 06231 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Kara E Anastasiou | 174 Graham Rd, South Windsor, CT 06074-1421 | Controlled Substance Registration for Practitioner | 2019-03-01 ~ 2021-02-28 |
| Roger A Graham Md | 761 River Road, Mystic, CT 06355-1234 | Controlled Substance Registration for Practitioner | 2009-03-01 ~ 2011-02-28 |
| Scott J Graham | 80 Seymour St Emergency Med, Hartford, CT 06102 | Controlled Substance Registration for Practitioner | 2008-03-01 ~ 2009-02-28 |
Please comment or provide details below to improve the information on NICOLE R GRAHAM.
| 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).